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目的 探讨心肌局部室壁收缩增厚率 (STR)与心肌局部室壁运动状态和冠状动脉 (简称冠脉 )狭窄程度间的关系及其临床意义。方法 对 34例冠心病 (CAD)患者和 8例正常受检者行静息99Tcm 甲氧基异丁基异腈 (MIBI)门控心肌断层显像。根据冠脉和左室造影所得冠脉狭窄程度和运动状态分组。取收缩末期和舒张末期图像计算STR值。结果 对照组和CAD无室壁运动异常组与室壁运动减弱组、无室壁运动组及矛盾运动组之间的STR值差异均有显著性 (P <0 .0 1或P <0 .0 5 ) ;对照组与冠脉轻度、中度、重度狭窄节段之间STR差异均有显著性 (P <0 .0 1或P <0 .0 5 ) ,且STR与该节段供血冠脉狭窄程度呈负相关 (r =- 0 .74,P <0 .0 1)。STR判定室壁运动异常的灵敏度为77 9% ,特异性为 90 .9% ;判断冠脉中度以上狭窄 (冠脉狭窄 >5 0 % )和重度狭窄 (冠脉狭窄 >80 % )的灵敏度分别为 5 3.8%和 73.4% ,特异性分别为 93.1%和 88.9%。结论 STR可比较准确地反映心肌局部室壁运动状态及局部供血冠脉的狭窄程度
Objective To investigate the relationship between local myocardial wall thickening (STR) and myocardial regional wall motion and the degree of coronary artery stenosis (coronary artery stenosis) and its clinical significance. Methods Thirty-four patients with coronary heart disease (CAD) and 8 normal subjects underwent resting 99Tcm methoxy-isobutyl isonitrile (MIBI) gated myocardial tomography. Coronary artery and left ventricular angiography based on the degree of coronary stenosis and exercise grouping. Taken from the end-systolic and end-diastolic images, STR values were calculated. Results There were significant differences in STR values between control group and CAD without wall motion abnormalities and those with weakened walls, non-wall motion and contractile exercise (P <0.01 or P <0 .0 5). There was significant difference in STR between control group and coronary artery in mild, moderate and severe stenosis (P <0.01 or P <0.05) Pulse stenosis was negatively correlated (r = - 0.74, P <0.01). The sensitivities of STR were 77.9% and specificity of 90.9%. The sensitivity of moderate to severe coronary stenosis (coronary artery stenosis> 50%) and severe stenosis (> 80% of coronary stenosis) 5 3.8% and 73.4% respectively, and the specificity was 93.1% and 88.9% respectively. Conclusion STR can be more accurately reflect the local ventricular wall motion and regional coronary artery stenosis