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目的:评价腺苷负荷心肌灌注单光子发射计算机断层扫描(SPECT)在诊断冠状动脉慢血流(CSF)中的临床价值。方法:根据冠状动脉造影(CAG)结果不同,分为CSF组、正常血流(NCF)组和CAG阳性组。使用校正的TIMI血流分级方法评价冠状动脉血流速度。3组均行CAG、静息心电图(ECG)、腺苷负荷ECG、静息及腺苷负荷SPECT检查,评价其心肌血流灌注情况。结果:CSF组腺苷负荷SPECT诊断心肌缺血阳性率(84%),明显高于平静ECG(20%)及腺苷负荷ECG(52%)。CSF组在腺苷负荷SPECT中显示心肌缺血的范围和程度高于NCF组,低于CAG阳性组。结论:CSF与心肌缺血关系密切,腺苷负荷SPECT可以作为检测CSF者心肌缺血的一种有效的无创性检查方法。
Objective: To evaluate the clinical value of adenosine stress myocardial perfusion single photon emission computed tomography (SPECT) in the diagnosis of chronic coronary artery disease. Methods: According to the result of coronary angiography (CAG), we divided into CSF group, normal blood flow (NCF) group and CAG positive group. Coronary flow velocities were assessed using a modified TIMI flow classification. CAG, resting electrocardiogram (ECG), adenosine stress ECG, resting and adenosine stress SPECT were performed in 3 groups. The myocardial perfusion was evaluated. Results: The positive rate of myocardial ischemia detected by adenosine load SPECT in CSF group (84%) was significantly higher than that of calm ECG (20%) and adenosine load ECG (52%). CSF group showed a greater extent and degree of myocardial ischemia in adenosine stress SPECT than NCF group and lower than CAG positive group. Conclusion: CSF is closely related to myocardial ischemia. Adenosine load SPECT can be used as an effective noninvasive method to detect myocardial ischemia in CSF.