三磷酸腺苷负荷心肌灌注显像在女性冠心病患者诊断中的价值

doi:10.13481/j.1671-587x.20160234

Abstract

Abstract:

Objective: To evaluate the value of adenosine triphophate (ATP) stress/rest nuclide myocardial perfusion imaging(MPI) in the diagnosis of female patients with coronary heart disease(CHD).Methods: The clinical materials of 47 female suspected CHD patients were retrospectively analyzed, aged from 39 to 74 years, and the average age was (53.7±6.3) years old.All patients were hospitalized and underwent two-day ATP stress and rest nuclide MPI and coronary angiography(CAG) in two weeks.The results and images of MPI and CAG were evaluated by more than 2 attending physicians.Using CAG as the "gold standard", the diagnostic efficiency (sensitivity, specificity and accuracy) of MPI for CHD was evaluated.Results: Compared with CAG, the sensitivity, specificity and accuracy of ATP stress MPI in diagnosing the female CHD patients were 81.3%(13/16), 77.4%(24/31)and 78.7%(37/47) individually;the positive predictive value and negative predictive value were 65.0%(13/20)and 88.9%(24/27).There were no severe adverse effects in the ATP stress test and the incidence of adverse effects was 85.1%.Conclusion: There is a highly diagnostic efficiency of ATP stress MPI in the CHD patients.It can be the first choice of examination methods for screening without injury and diagnosing the myocardial ischemia in the female patients.

Key words: adenosine triphosphate, myocardial perfusion imaging, coronary heart disease, female

CLC Number:

R817.4

JIANG Wenping, HOU Sen, LIN Qiuyu, GU Li, ZHAO Hongguang. Value of adenosine triphosphate stressand rest nuclide myocardial perfusion imaging in diagnosis of female patients with coronary heart disease[J].Journal of Jilin University Medicine Edition, 2016, 42(02): 370-374.

References

[1] Bairey M,Shaw LJ,Reis SE,et al. Insights from the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation(WISE) Study:Part Ⅱ:gender differences in presentation,diagnosis,and outcome with regard to gender-based pathophysiology of atherosclerosis and macrovascular and microvascular coronary disease[J].JAm Coll Cardiol,2006,47(3s1):21-29.

[2] Klocke FJ,Baird MG,Lorell BH,et al.ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging-executive summary:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines(ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging)[J].J Am Coll Cardiol,2003,42(7):1318-1333.

[3] 国家卫生和计划生育委员会.2013中国卫生和计划生育统计年鉴[M].北京:中国协和医科大学出版社,2013.

[4] Mosca L,Appel LJ,Benjamin EJ,et al.Evidence-based guidelines for cardiovascular disease prevention in women[J].Circulation,2004,109(5):672-693.

[5] Johnson BD,Shaw LJ,Buchthal SD,et al.Prognosis in women with myocardial ischemia in the absence of obstructive coronary disease:results from the National Institutes of Health-National Heart,Lung,and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation(WISE)[J].Circulation,2004,109(24):2993-2999.

[6] Maseri A.Women's Ischemic Syndrome Evaluation:current status and future research directions:report of the National Heart,Lung and Blood Institute Workshop:October 2-4,2002:perspective:new frontiers in detection of ischemic heart disease in women[J]. Circulation,2004,109(6):e62-e63.

[7] 郭丽君.冠状动脉功能学评价与女性心肌缺血[J].中国心血管杂志,2015,20(4):247-249.

[8] Pijls NH,Van Schaardenburgh P,Manoharan G,et al.Percutaneous coronary intervention of functionally nonsignificant stenosis:5-year follow-up of the DEFER Study[J].J Am Coll Cardiol,2007,49(21):2105-2111.

[9] Schepis T,Benz K,Haldemann A,et al.Prognostic value of stress-gated 99m-technetium SPECT myocardial perfusion imaging:risk stratification of patients with multivessel coronary artery disease and prior coronary revascularization[J].J Nucl Cardiol,2013,20(5):755-762.

[10] 付瑛,王蒨.冠心病危险度分层的无创性影像技术研究进展[J].心肺血管病杂志,2014,33(2):305-307.

[11] 朱传明,杨淑贞,邱进,等.三磷酸腺苷二钠负荷心肌灌注显像在冠心病诊治中的临床应用[J].实用医技杂志,2013,20(6):594-596.

[12] 李家俊,田月琴,何作祥.腺苷及选择性A2a受体激动剂regadenoson心肌负荷试验[J].中华核医学与分子影像杂志,2012,32(1):75-78.

[13] 刘诗燕,蒋婷,袁丽萍,等.三磷酸腺苷负荷试验致过敏反应一例[J].华西医学,2015,30(5):994-995.

[14] 谢梦梦,张遵城,董萍,等.腺苷负荷^99mTc-MIBI心肌灌注显像在更年期女性冠心病中的诊断价值[J].实用医学杂志,2013,29(22):3703-3704.

[15] 赵娜,宋丽萍.门控心肌灌注显像对冠状动脉粥样硬化性心脏病的诊断及评估价值[J].解放军医学院学报,2014,35(1):52-55.

[16] Kapur A,Latus KA,Davies G,et al.A comparison of three radionuclide myocardial perfusion tracers in clinical practice:the ROBUST study[J].Eur J Nucl Med Mol Imaging,2002,29(12):1608-1616.

Value of adenosine triphosphate stressand rest nuclide myocardial perfusion imaging in diagnosis of female patients with coronary heart disease

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 0

[1]	ZHU Tao, ZHANG Guoming, YAN Fei, LIU Zheng, HUO Qiang. Comparison of diagnostic values between myocardial perfusion imaging and dual source CT coronary angiography in coronary artery stenosis in patients with diabetes complicated with coronary heart disease [J]. Journal of Jilin University Medicine Edition, 2018, 44(02): 425-430.
[2]	ZHENG Dongchun, ZHANG Tianrong, LIU Hongbo, CHEN Huaiji, WANG Qi, XU Feng, ZHANG Yuezhu, ZHOU Liting, YE Lin. Association between genetic variations in 9p21 region and coronary heart disease in Chinese Han population [J]. Journal of Jilin University Medicine Edition, 2018, 44(01): 142-146.
[3]	ZHANG Yang, WANG Junfeng, CAOHongyan, QIN Ling, XU Guoliang. Effectiveness and safety of Dengzhanhuasu and Dansheng Injection in treatment of patients with angina pectoris of coronary heart disease:A Meta-analysis [J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 317-321.
[4]	WU Juan, JIA Yiyang, LIU Te, ZHOU Liting, SUN Di, XU Jin, LI Chunyan, WANG Shuyue, YU Lei, YE Lin. Analysis on association between single nucleotide polymorphisms of ACE gene and susceptibility of coronary heart disease [J]. Journal of Jilin University Medicine Edition, 2015, 41(04): 825-829.
[5]	. Effect of atrazine on levels of serum sex hormone in healthy female mice and its significance [J]. Journal of Jilin University Medicine Edition, 2013, 39(6): 1169-1172.
[6]	XIAO Hui-jie,YAO Cheng,SHEN Zhen,YU Wei,ZHANG Kai,LIU Tong-jun,JIANG　Yang. Effect of HIF-1α on proliferation of rectal cancer HT-29 cells [J]. Journal of Jilin University Medicine Edition, 2013, 39(1): 51-55.
[7]	LIU Cheng-bin,WU Hai-di,LI Jing,XU Guo-liang,QIN Ling. Association \|between matrix metalloproteomase-9 polymorphism and \|coronary heart disease [J]. J4, 2012, 38(4): 755-760.
[8]	SUN Lin\|LIAO Yu\|YE Lin\|CAO Hong-qian\|CHEN Yu-xi\|QIN Ling\|XIE Lin. Association analysis between \|polymorphisms of FADS1/FADS2 gene and coronary heart disease [J]. J4, 2012, 38(1): 115-118.
[9]	TIAN Li-Ming, XIE Hong-Fu, YANG Ting, WANG Wei-Zhen, LI Ji. Relevance analysis on E211 G>A androgen receptor gene polymorphism and 　 female postadolescent acne in Han population [J]. J4, 2011, 37(1): 113-116.
[10]	LU Ming-Yue, LI Zhi-Jun, WANG Zhi-Feng. Effect \|of weight loss on functional state of female judokas [J]. J4, 2009, 35(6): 1142-1146.
[11]	WUYuan, GAO Dong-Mei, SONG Jun, ZHOU Xue-Yan, MENG Fan-Bo, ZENG Hong. Effect of trimetazine on vascular endothelial function in patients with coronary heart disease [J]. J4, 2009, 35(4): 685-689.
[12]	ZHAO Rui, GUO Cai-xia,CHU Qui,YANG Chun-mei,ZHAO Fu-di. Changes of myocardium pathology and free radicals in experimental AMI 　rats treated with magnetic field [J]. J4, 2008, 34(4): 640-644.
[13]	SONG Cui-miao,DU Hui-lan,DUAN Yan-cang,MA Hui-rong,LI Guo-ming,ZHANG Xue-jing. Changes of transforming growth factor β1 and its receptor in uterus in androgen-induced sterile rats [J]. J4, 2007, 33(4): 708-711.
[14]	WANG Ling-yan, CAI Gao-jun,SUN Wen-wei,ZHANG Wen-wei,WANG Wen-zhi,YAN Wei-qun. Levels of pregnancy-associated plasma protein-A inpatientswith coronary heart diseases and clinic significance [J]. J4, 2006, 32(2): 334-337.
[15]	LI Shu-hong,DAI Pei,CUI Li-ming, ZONG Shan, ZUO Wen-jing. Infection rate of Toxoplasma gondii and age distributionin female patients with sterility [J]. J4, 2006, 32(1): 163-2.