摘要
目的：研究不稳定型心绞痛患者99mTc-甲氧基异丁基异腈（MIBI）负荷/静息门控心肌灌注显像危险度分层与全球急性冠状动脉事件注册（GRACE）评分的相关性。方法：2006年6月~2007年11月确诊为不稳定型心绞痛的住院患者37例。首先依据GRACE评分方法进行评分；然后行99mTc-MIBI运动或腺苷负荷门控心肌灌注显像和静息心肌灌注显像，依据负荷/静息门控心肌灌注显像所测定的可逆性心肌缺血计分值（SDS）和负荷后左室射血分数（LVEF）将患者分为低危组和中危组。分析99mTc-MIBI负荷/静息门控心肌灌注显像危险分层与GRACE评分的相关性。结果：37例患者均顺利完成99mTc-MIBI运动或腺苷负荷门控心肌灌注显像和静息心肌灌注显像。低危组和中危组之间的GRACE评分有显著差异（P<0.01）。GRACE评分与负荷状态下心肌缺血计分值（SSS）呈正相关（r＝0.561，P<0.01），与SDS呈正相关（r＝0.623，P<0.01），与静息状态下心肌缺血计分值（SRS）无关（r＝0.175，P>0.05）。结论：GRACE评分对不稳定型心绞痛患者的核素心肌灌注显像危险度分层有一定的预测价值。
Abstract
Objective: To investigate the correlation of the risk stratification of 99mTc-MIBI gated stress-rest myocardial perfusion imaging(MPI) and the global registry of acute coronary events(GRACE) risk score in patients with unstable angina(UA). Methods: Thirty-seven patients with determinated UA were enrolled in the study. At first, the GRACE risk scores were evaluated according to the baseline characteristics on admission. And then all the patients received the 99mTc-MIBI exercise or adenosine stress-rest gated MPI in two days. Based on the summed difference score(SDS) and post-stress left ventricular ejection fraction(LVEF) of MPI, the patients were classified into 2 groups: the low risk group and the moderate risk group. The correlation of the risk stratification assessed by MPI and the GRACE risk score were analysed. Results: All the 37 patients completed the 99mTc-MIBI gated stress-rest MPI successfully. Based on the risk stratification of MPI, 24 patients were in low risk group and 13 in moderate risk group. The GRACE risk scores in moderate risk group were obviously higher than those in low risk group(P<0.05). The relevant analysis showed that the GRACE risk score was positively correlated with the summed stress score(r＝0.561, P<0.01) and the summed difference score(r＝0.623, P<0.01), and had no relation with the summed rest score(r＝0.175, P>0.05). Conclusion: In UA patients, the GRACE risk score has certain predicting value in the risk stratification of MPI.
关键词
心绞痛 /
不稳定型 /
99m锝甲氧基异丁基异腈
Key words
Angina /
unstable /
Technetium tc 99m sestamibi
田爱娟;赵 明;季晓鹏;于 璟;周冬莉;张宏伟.
不稳定型心绞痛患者全球急性冠状动脉事件注册评分与心肌灌注显像危险分层的相关研究[J]. 中国临床医学影像杂志. 2008, 19(9): 631-634
TIAN Ai-juan;ZHAO Ming;JI Xiao-peng;YU Jing;ZHOU Dong-li;ZHANG Hong-wei.
Relationship between the GRACE risk score and the risk stratification of myocardial perfusion imaging in patients with unstable angina[J]. Journal of China Clinic Medical Imaging. 2008, 19(9): 631-634
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