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目的 :与18F 脱氧葡萄糖单光子发射计算机断层摄影术 (SPECT)心肌代谢显像对比 ,评价不同小剂量多巴酚丁胺超声心动图 ,检测冠心病左心室收缩功能严重受损患者存活心肌的准确性和安全性。方法 :冠心病心肌梗死伴左心室收缩功能严重受损 (平均左心室射血分数 0 3 8± 0 0 5 )的患者 3 3例 ,1周内分别进行不同小剂量多巴酚丁胺 [3、5、10 μg/(kg·min) ]超声心动图和99m锝 甲氧基异丁基、18F 脱氧葡萄糖SPECT心肌灌注及代谢显像。图像分析均采用 16节段半定量法。以18F 脱氧葡萄糖SPECT检测结果为标准 ,评价不同小剂量多巴酚丁胺超声心动图检测存活心肌的敏感性、特异性、准确性和安全性。结果 :3 3例患者的 3 65个运动异常节段中存活心肌检出率 :18F 脱氧葡萄糖SPECT心肌代谢显像检出的存活心肌节段为 67 4% ,多巴酚丁胺 3、5和 10 μg/(kg·min)分别为 3 8 9%、61 4%和 70 4%。多巴酚丁胺 3 μg/(kg·min)检出的存活心肌节段显著低于18F 脱氧葡萄糖SPECT心肌代谢显像检出的存活心肌节段 (P <0 0 0 1)。多巴酚丁胺 3、5、10μg/(kg·min)超声心动图检出存活心肌的敏感性分别为 5 1 6%、82 9%和 91 8% ,准确性分别为 63 6%、81 6%和87 8% ,均显著递增 (P <0 0 5～ 0 0 0 1) ;副作用发生率分别?
OBJECTIVE: To evaluate the efficacy of different low-dose dobutamine echocardiography in the detection of viable myocardium in patients with severely impaired left ventricular systolic function in patients with coronary heart disease compared with 18F deoxyglucose single photon emission computed tomography (SPECT) myocardial metabolic imaging Sexuality and safety. Methods: Thirty-three patients with severe myocardial infarction and severe left ventricular systolic dysfunction (mean left ventricular ejection fraction 0 38 ± 0 05) were treated with different doses of dobutamine [3 , 5,10 μg / (kg · min)] echocardiography and 99m Tc methoxyisobutyl, 18F deoxyglucose SPECT myocardial perfusion and metabolic imaging. Image analysis using 16-segment semi-quantitative method. The sensitivity, specificity, accuracy and safety of different small doses of dobutamine echocardiography in detecting viable myocardium were evaluated by 18F deoxyglucose SPECT test. Results: The detection rate of viable myocardium in 3 65 patients with abnormal motion segments was 67 4%, 18 4% in doxycycline SPECT myocardial metabolic imaging, 10 μg / (kg · min) were 389%, 61 4% and 70 4%, respectively. The viable myocardium detected by dobutamine at 3 μg / (kg · min) was significantly lower than the viable myocardium detected by 18F deoxyglucose SPECT myocardial metabolic imaging (P <0.01). The sensitivity of dobutamine at 5, 10 and 10 μg / (kg · min) echocardiography was 51.6%, 82.9% and 91.8% respectively, with the accuracy of 63.6% and 81% respectively 6% and 87 8% respectively, all increased significantly (P <0.05-0.01). The incidence of side effects were respectively