心肌灌注断层闪烁显像检测隐匿性冠心病病灶体积对心室舒缩功能的影响

发布时间：2018-05-16 21:37

本文选题：隐匿性冠心病 + 心肌梗塞　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的:以隐匿性冠心病患者病灶多发与单发代表病灶体积大小来分析隐匿性冠心病患者病灶体积对心肌舒缩功能的影响。探究核素心肌血流灌注显像和平衡门控法心血池显像在隐匿性冠心病诊断中的价值。方法:本课题研究对象选取了38例隐匿性冠心病患者及23名陈旧性心肌梗死病史患者。以上患者均进行核素心肌血流灌注显像观察左心室各部分室壁放射性变化,而后进行平衡门控法心血池显像以获得心肌功能的定量分析参数,包括高峰射血率(PER)、高峰充盈率(PFR)、左室射血分数(LVEF)、高峰充盈时间(TPFR)及局部射血分数(REF)、局部室壁轴缩短率(RS)。对上述心肌功能参数进行分析时,首先进行隐匿性冠心病组与心肌梗死组的对比分析,然后对隐匿性冠心病组按照病灶单发与多发分组进而进行病灶单发组与多发组的对比分析,统计学采用SPSS Statistics 19.0统计学分析软件,分析方法为独立样本t检验,P0.05为差异有统计学意义。结果:核素心肌血流灌注成像显示隐匿性冠心病组表现为可逆性的放射性缺损,心肌梗死组表现为不可逆的放射性缺损,即为固定性缺损,缺损范围均局限在部分室壁。隐匿性冠心病组与心肌梗死组的对比中,门控法心室功能显像获得的各项心功能参数上,左室射血分数、高峰射血速率和高峰充盈速率的差别均具有显著的统计学意义(P0.01);隐匿性冠心病病灶单发组与多发组的对比中,左室射血分数的差别有统计学意义(P0.05)。结论:隐匿性冠心病组及心肌梗死组核素心肌血流灌注成像分别表现为可逆性的放射性缺损及固定性放射缺损,缺损范围均局限在部分室壁。因此,这两种疾病可根据核素心肌血流灌注成像的检查结果相互鉴别。隐匿性冠心病对心肌的损害明显低于心肌梗死,隐匿性冠心病病灶多发对心肌舒缩功能损害高于单发,即病灶体积对心肌的舒缩功能损害存在影响。
[Abstract]:Aim: to analyze the effect of volume of occult coronary heart disease on myocardial systolic and diastolic function. To explore the value of radionuclide myocardial perfusion imaging and balanced gated cardiac blood pool imaging in the diagnosis of occult coronary heart disease. Methods: 38 patients with occult coronary heart disease and 23 patients with old myocardial infarction history were selected. The radionuclide myocardial perfusion imaging was performed to observe the changes of left ventricular wall radioactivity, and then the quantitative parameters of myocardial function were obtained by balanced gated blood pool imaging. These include peak ejection rate, peak filling rate, left ventricular ejection fraction (LVEF), peak filling time (TPFR), local ejection fraction (REFN), and local ventricular wall shortening rate (RSV). When analyzing the above mentioned myocardial function parameters, the comparative analysis was made between the occult coronary heart disease group and the myocardial infarction group. Then the patients with occult coronary heart disease were divided into single focus group and multiple group according to the lesion, and then the single focus group and the multiple group were compared and analyzed. SPSS Statistics 19.0 software was used to analyze the statistics. The analysis method was independent sample t test (P 0.05), the difference was statistically significant. Results: radionuclide myocardial perfusion imaging showed reversible radioactive defect in patients with occult coronary heart disease and irreversible radioactive defect in myocardial infarction group. Left ventricular ejection fraction (LVEF) was measured by gated ventricular function imaging in patients with occult coronary heart disease (CHD) and myocardial infarction (MI). The difference of peak ejection rate and peak filling rate was significant (P 0.01), and the difference of left ventricular ejection fraction was significant in the single and multiple groups of occult coronary heart disease. Conclusion: the radionuclide myocardial perfusion imaging in the occult coronary heart disease group and myocardial infarction group showed reversible radiation defect and fixed radiation defect respectively, and the defect scope was limited to part of the ventricular wall. Therefore, the two diseases can be distinguished by radionuclide myocardial perfusion imaging. The myocardial damage of occult coronary heart disease was significantly lower than that of myocardial infarction, and the damage of myocardial systolic and diastolic function was higher than that of occult coronary heart disease, that is, the volume of lesion had an effect on myocardial systolic and diastolic function damage.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4;R816.2

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