目的：应用核素门控心肌灌注显像（Gated SPECT myocardial perfusion imaging，GSMPI）评估不同阶段的冠心病患者心脏收缩同步性的变化规律，探讨收缩不同步与冠心病进展的相关性。方法：回顾性分析既往行GSMPI的检查者94例，其中正常对照组40例、冠心病轻度心肌缺血组20例、冠心病中度心肌缺血组16例、冠心病重度心肌缺血组18例。应用Emory Cardiac Toolbox软件计算同步性参数：相位直方图带宽（Phase histrogram bandwidth，PHB）及相位标准差（Phase standard deviation，PSD）；心肌血流定量参数：负荷显像总积分（Summed stress scores，SSS）、静息显像总积分（Summed rest scores，SRS）及总积分差（Summed difference scores，SDS）。分别比较3组心肌缺血患者与正常对照组的PHB、PSD；比较3组心肌缺血组间的PHB、PSD；分析PHB、PSD与SSS、SDS的相关性。结果：正常对照组与轻度心肌缺血组的PHB、PSD无明显统计学差异；对照组与中度心肌缺血组、重度心肌缺血组的PHB、PSD均有明显统计学差异；PHB、PSD与SSS、SDS均呈明显正相关。结论：冠心病患者心脏收缩失同步程度随心肌缺血严重程度的加重而进展；GSMPI能够“一站式”提供心肌缺血及心脏收缩同步性参数，对筛选存在心脏收缩失同步的早期冠心病患者具有一定的临床应用价值。
Abstract
Objective: To assess the change rule of the cardiac systolic dyssynchrony in patients with coronary heart disease in different stage by gated SPECT myocardial perfusion image(GSMPI). Method: A retrospective analysis was made at 94 cases with GSMPI, including the healthy people(control group, 40 cases), mild myocardial ischemia group(20 cases), moderate myocardial ischemia group(16 cases) and severe myocardial ischemia group(18 cases). The software named Emory Cardiac Toolbox was used to process the data, and the systolic synchrony parameters were acquired, including phase histogram bandwidth(PHB), phase standard deviation(PSD). Myocardial blood flow parameters included summed stress score(SSS), summed rest score(SRS) and summed difference score(SDS). The difference of PHB, PSD between the myocardial ischemia group and the control group separately were compared. The difference among the three myocardial ischemia groups were studied. The relationship among the PHB, PSD and SSS and SDS were analyzed. Result: For PHB and PSD, there’s no obvious difference between the mild myocardial ischemia group and the control group(P>0.05); There have significant different exits among moderate, severe myocardial ischemia group and the control group(P<0.05). PHB and PSD were both positively correlated obviously with SSS and SDS. Conclusion: The progress of cardiac systolic dyssynchrony happened with the aggravation of myocardial ischemia in patients with coronary heart disease. GSMPI can supply systolic synchrony and myocardial ischemia parameters by “one stop”, has certain application value in choosing the early coronary heart disease patients with cardiac systolic dyssynchrony.
关键词
/
冠状动脉疾病 /
放射性核素显像
Key words
Coronary disease /
Radionuclide imaging
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基金
天津滨海新区卫生科技项目（2014BWKY019）；天津市卫生局科技基金（2015KZ009）。
