[1]郝亚逢,张利峰,王学智,等.99mTc-MIBI门控心肌灌注显像对行沙库巴曲缬沙坦治疗的冠心病患者心肌血流灌注及心功能的评估价值[J].陕西医学杂志,2024,(4):514-517,522.[doi:DOI:10.3969/j.issn.1000-7377.2024.04.017]
 HAO Yafeng,ZHANG Lifeng,WANG Xuezhi,et al.Evaluation value of 99mTc MIBI GMPI on myocardial blood flow perfusion and cardiac function in patients with coronary heart disease undergoing sacubarta valsartan treatment[J].,2024,(4):514-517,522.[doi:DOI:10.3969/j.issn.1000-7377.2024.04.017]
点击复制

99mTc-MIBI门控心肌灌注显像对行沙库巴曲缬沙坦治疗的冠心病患者心肌血流灌注及心功能的评估价值
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年4期
页码:
514-517,522
栏目:
临床研究
出版日期:
2024-04-05

文章信息/Info

Title:
Evaluation value of 99mTc MIBI GMPI on myocardial blood flow perfusion and cardiac function in patients with coronary heart disease undergoing sacubarta valsartan treatment
作者:
郝亚逢1张利峰2王学智1李 远3苗 睿1王献忠1武国霞4
(1.邯郸市第一医院心内二科,河北 邯郸 056000; 2.河北工程大学附属医院心内一科,河北 邯郸 056008; 3.石家庄市第四医院急诊科,河北 石家庄 050035; 4.邯郸市涉县医院老年医学科,河北 邯郸 056499)
Author(s):
HAO YafengZHANG LifengWANG XuezhiLI YuanMIAO RuiWANG XianzhongWU Guoxia
(Department of Cardiology,Handan First Hospital,Handan 056000,China)
关键词:
99mTc-MIBI 门控心肌灌注显像 冠心病 沙库巴曲缬沙坦 心肌血流灌注 心功能
Keywords:
99mTc-MIBI gated myocardial perfusion imaging Coronary heart disease Sacubatrol valsartan Myocardial blood perfusion Cardiac function
分类号:
R 543.3
DOI:
DOI:10.3969/j.issn.1000-7377.2024.04.017
文献标志码:
A
摘要:
目的:探究99mTc-MIBI门控心肌灌注显像(GMPI)评估冠心病患者沙库巴曲缬沙坦治疗后心肌血流灌注及心功能的价值。方法:选取冠心病患者78例,入组患者均接受沙库巴曲缬沙坦治疗,采用99mTc-MIBI GMPI对患者的心肌血流灌注情况及心功能指标进行检测,并以超声心动图及冠状动脉造影结果为参照,对99mTc-MIBI GMPI检查的准确性进行探究。结果:患者经冠状动脉造影检查结果与患者经99mTc-MIBI GMPI检查心肌血流灌注结果比较无统计学差异(P>0.05),经卡帕一致性检验,KAPPA值为0.826,一致性较好。 患者经冠状动脉造影检查结果与患者经99mTc-MIBI GMPI心功能结果[舒张末期容积(EDV)、收缩末期容积(ESV)、左心室射血分数(LVEF)、心输出量(CO)]比较无统计学差异(均P>0.05),经ICC一致性检验,ICC=0.812,一致性较好。治疗后与治疗前比较,患者的心肌血流灌注有所好转,患者完全闭塞、重度狭窄占比降低,轻度狭窄占比升高(均P<0.05)。与治疗前比较,治疗后患者的EDV、ESV水平降低,LVEF、CO升高(均P<0.05)。78例患者经过治疗,出现8例症状性低血压,2例轻度血管性水肿,6例肾功能损伤,3例高钾血症,并发症发生率约为24.36%。结论:99mTc-MIBI GMPI评估心肌血流灌注及心功能情况与超声心动图及冠状动脉造影结果相一致,可以准确地反映冠心病患者经沙库巴曲缬沙坦治疗后的心肌血流灌注及心功能变化。经沙库巴曲缬沙坦治疗,患者的心肌血流灌注及心功能得到改善,但需要对患者的不良反应情况进行关注。
Abstract:
Objective:To investigate the value of 99mTc-MIBI gated myocardial perfusion imaging(GMPI)in evaluating myocardial blood flow perfusion and cardiac function in patients with coronary heart disease after treatment with sacubactril and valsartan.Methods:Seventy-eight patients with coronary heart disease were selected,and all the enrolled patients received sacubatrotril and valsartan treatment.The myocardial blood perfusion and cardiac function indexes of the patients were detected using 99mTc-MIBI GMPI,and the results of echocardiography and coronary angiography were used as reference.The accuracy of 99mTc-MIBI GMPI test was investigated.Results:There was no difference between the results of coronary angiography and those of 99mTc-MIBI GMPI(P>0.05),after kappa consistency test,kappa value was 0.826,indicating good consistency.There was no difference between the coronary angiography and 99mTc-MIBI GMPI cardiac function results(EDV,ESV,LVEF,CO)(all P>0.05).After ICC consistency test,ICC was 0.812,with good consistency.After treatment,compared with before treatment,the myocardial blood perfusion of patients improved,the proportion of patients with complete occlusion and severe stenosis decreased,and the proportion of patients with mild stenosis increased(all P<0.05).Compared with before treatment,the EDV and ESV levels of patients after treatment were decreased,while LVEF and CO were increased(all P<0.05).Of the 78 patients treated,8 had symptomatic hypotension,2 had mild angioedema,6 had renal injury,and 3 had hyperkalemia.The complication rate was 24.36%.Conclusion:The 99mTc-MIBI GMPI assessment can accurately reflect the myocardial blood perfusion and cardiac function changes in patients with coronary heart disease after treatment with sacubatrotril and valsartan,which is consistent with the results of echocardiography and coronary angiography.After treatment with sacubatrotril and valsartan,the myocardial blood perfusion and cardiac function of the patients were significantly improved,but the adverse reactions of the patients should be paid attention to.

参考文献/References:

[1] VOUTILAINEN A,BRESTER C,KOLEHMAINEN M,et al.Epidemiological analysis of coronary heart disease and its main risk factors:Are their associations multiplicative,additive,or interactive?[J].Annals of Medicine,2022,54(1):1500-1510.
[2] SHAYA G E,LEUCKER T M,JONES S R,et al.Coronary heart disease risk:Low-density lipoprotein and beyond[J].Trends in Cardiovascular Medicine,2022,32(4):181-194.
[3] 肖翔,彭飞,周瑞.血清N端脑钠肽前体、肌红蛋白、D-二聚体水平与冠心病患者心室重构和主要心血管不良事件关系分析[J].陕西医学杂志,2023,52(6):697-700.
[4] 宋晓龙,宋俊,潘仁友,等.利心水方治疗冠心病心力衰竭疗效及对患者心肌纤维化、心肌重构的影响[J].陕西中医,2022,43(2):197-200.
[5] 吴超群,李希,路甲鹏,等.中国居民心血管疾病危险因素分布报告[J].中国循环杂志,2021,36(1):4-13.
[6] 刘菲,杨文灿.沙库巴曲缬沙坦对扩张型心肌病心力衰竭患者心室重构和心脏功能的影响[J].中南医学科学杂志,2023,51(2):222-225.
[7] 徐欢欢,薛莉.沙库巴曲缬沙坦对射血分数保留心力衰竭的影响[J].宁夏医科大学学报,2022,44(10):1024-1028.
[8] 陆敏,杨德斌,王迎春,等.心肌造影评价ST段抬高型心肌梗死PCI术后心肌微循环灌注异常及其预后价值[J].中国超声医学杂志,2023,39(2):158-162.
[9] 武玉多,贡鸣,谷孝艳,等.机器学习在心脏超声领域中的研究进展[J].临床超声医学杂志,2021,23(9):692-694.
[10] 浙江省核医学中心,浙江省医学会核医学与放射医学防护分会质控学组.浙江省99mTc-MIBI SPECT心肌灌注显像检查规范及质量控制专家共识(2020版)[J].浙江医学,2021,43(2):117-123,147.
[11] 赵敏,卢霞,田毅,等.门控SPECT心肌灌注显像相位分析评估左心室收缩同步性对室壁瘤患者长期预后的临床价值[J].心肺血管病杂志,2018,37(2):140-145.
[12] 战莹,王治国,武晓丹,等.99mTc-MIBI门控SPECT/CT心肌灌注显像评估2型糖尿病患者左心室功能价值[J].临床军医杂志,2018,46(11):1279-1281,1284.
[13] 屈娟娟.冠心病颈动脉超声参数AC、β及IMT与冠状动脉病变的关系[J].分子诊断与治疗杂志,2022,14(10):1811-1814.
[14] 雷悦云,邵磊,高传玉,等.早发冠心病发病机制相关基因多态性研究进展[J].心血管病学进展,2023,44(4):331-335.
[15] DOCHERTY K F,VADUGANATHAN M,SOLOMON S D,et al.Sacubitril/Valsartan[J].JACC:Heart Failure,2020,8(10):800-810.
[16] MEHRAN R,STEG P G,PFEFFER M A,et al.The effects of angiotensin receptor-neprilysin inhibition on major coronary events in patients with acute myocardial infarction:Insights from the PARADISE-MI trial[J].Circulation,2022,146(23):1749-1757.
[17] YAMANAKA M,TAKAO S,OTSUKA H,et al.The utility of a combination of 99mTc-MIBI washout imaging and cardiac magnetic resonance imaging in the evaluation of cardiomyopathy[J].Annals of Nuclear Cardiology,2021,7(1):8-16.
[18] 周凡,汪建强,陈春梦,等.ATP负荷99mTc-MIBI门控SPECT/CT心肌灌注显像在心脏X综合征的诊治应用[J].心血管病学进展,2020,41(9):989-993.
[19] ABDIN A,SCHULZ M,RIEMER U,et al.Sacubitril/valsartan in heart failure:Efficacy and safety in and outside clinical trials[J].ESC Heart Failure,2022,9(6):3737-3750.
[20] MANN D L,GIVERTZ M M,VADER J M,et al.Effect of treatment with sacubitril/valsartan in patients with advanced heart failure and reduced ejection fraction[J].JAMA Cardiology,2022,7(1):17.
[21] MANN D L,GREENE S J,GIVERTZ M M,et al.Sacubitril/Valsartan in advanced heart failure with reduced ejection fraction:Rationale and design of the LIFE trial[J].JACC Heart Fail,2020,8(10):789-799.
[22] PIESKE B,WACHTER R,SHAH S J,et al.Effect of sacubitril/valsartan vs standard medical therapies on plasma nt-probnp concentration and submaximal exercise capacity in patients with heart failure and preserved ejection fraction[J].JAMA,2021,326(19):1919.
[23] EMDIN M,AIMO A,CASTIGLIONE V,et al.Targeting cyclic guanosine monophosphate to treat heart failure[J].Journal of the American College of Cardiology,2020,76(15):1795-1807.
[24] 侯琳琳,冯俊.沙库巴曲缬沙坦对行急诊PCI术的急性前壁心肌梗死病人左心室重塑指标及心功能的影响[J].蚌埠医学院学报,2023,48(4):493-497.

相似文献/References:

[1]杨 铮,黄 萍△,杨 阳,等.西安地区中老年人血清尿酸检测的临床价值研究*[J].陕西医学杂志,2019,(7):951.
 YANG Zheng,HUANG Ping,YANG Yang,et al.Clinical value of serum uric acid in middle-aged and elderly patients in Xi’an[J].,2019,(4):951.
[2]董 昕,杨朋康△.单硝酸异山梨酯联合维拉帕米对冠心病稳定型心绞痛患者血脂水平及血清同型半胱氨酸、高敏C反应蛋白的影响*[J].陕西医学杂志,2020,49(4):485.
 DONG Xin,YANG Pengkang..Effect of isosorbide mononitrate combined with verapamil on blood lipids levels and serum HCY and hs-CRP in patients with stable angina pectoris[J].,2020,49(4):485.
[3]张美娜,张 斌△.慢性牙周炎合并冠心病患者血清Vaspin、Apelin、Chemerin水平与牙周临床指数相关性探讨*[J].陕西医学杂志,2020,49(5):557.
 ZHANG Meina,ZHANG Bin..Correlation between serum Vaspin,Apelin,Chemerin levels and periodontal clinical index in patients with chronic periodontitis and coronary heart disease[J].,2020,49(4):557.
[4]陈伟国,朱萧玲,常 盼,等.2型糖尿病患者冠状动脉狭窄程度危险因素分析*[J].陕西医学杂志,2020,49(6):672.[doi:DOI:10.3969/j.issn.10007377.2020.06.008]
 CHEN Weiguo,ZHU Xiaoling,CHANG Pan,et al.Risk factors of coronary stenosis in patients with type 2 diabetes mellitus[J].,2020,49(4):672.[doi:DOI:10.3969/j.issn.10007377.2020.06.008]
[5]李 垚,陈万林,杨 平,等.亚甲基四氢叶酸还原酶基因C677T多态性与冠心病患者冠状动脉病变及叶酸水平相关性研究[J].陕西医学杂志,2021,50(1):22.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.005]
 LI Yao,CHEN Wanlin,YANG Ping,et al.Correlation of methylenetetrahydrofolate reductase gene C677T polymorphism with coronary artery disease and folic acid level in patients with coronary heart disease[J].,2021,50(4):22.[doi:DOI:10.3969/j.issn.1000-7377.2021.01.005]
[6]尹小花,徐 荣,郭 鑫,等.冠状动脉CT血管造影预测冠脉斑块患者发生左心室重构临床价值研究[J].陕西医学杂志,2021,50(2):192.[doi:DOI:10.3969/j.issn.1000-7377.2021.02.017]
 YIN Xiaohua,XU Rong,GUO Xin,et al.Coronary CTA in prediction of left ventricular remodel in patients with coronary plaque[J].,2021,50(4):192.[doi:DOI:10.3969/j.issn.1000-7377.2021.02.017]
[7]罗 薇,韩 勇,王莉萍,等.西地兰联合贝那普利对老年冠心病心力衰竭患者心功能及金属蛋白酶组织抑制因子-4、游离脂肪酸表达的影响[J].陕西医学杂志,2021,50(2):216.[doi:DOI:10.3969/j.issn.1000-7377.2021.02.023]
 LUO Wei,HAN Yong,WANG Liping,et al.Effects of cedilan and benazepril on cardiac function and expression of TIMP-4 and FFA in elderly patients with coronary heart disease and heart failure[J].,2021,50(4):216.[doi:DOI:10.3969/j.issn.1000-7377.2021.02.023]
[8]姜 育,张 洁,陈 群,等.心外膜脂肪组织厚度对2型糖尿病合并冠心病患者血管事件发生的预测价值[J].陕西医学杂志,2021,50(5):542.[doi:DOI:10.3969/j.issn.1000-7377.2021.05.007]
 JIANG Yu,ZHANG Jie,CHEN Qun,et al.Value of epicardial adipose tissue thickness in predicting the occurrence of vascular events in patients with type 2 diabetes and coronary heart disease[J].,2021,50(4):542.[doi:DOI:10.3969/j.issn.1000-7377.2021.05.007]
[9]刘博强,张伟宁,忽海洋.miRNA-26a-5p靶向调控蛋白酪氨酸磷酸酶基因对冠心病模型大鼠主动脉内皮细胞炎症损伤的影响[J].陕西医学杂志,2021,50(11):1349.[doi:DOI:10.3969/j.issn.1000-7377.2021.11.007]
 LIU Boqiang,ZHANG Weining,HU Haiyang.Effect of targeted regulation of protein tyrosine phosphatase gene by miRNA-26a-5p on inflammatory injury of aortic endothelial cells in rats with coronary heart disease[J].,2021,50(4):1349.[doi:DOI:10.3969/j.issn.1000-7377.2021.11.007]
[10]王 晶,刘易婷,刘 哲.替米沙坦联合瑞舒伐他汀治疗糖尿病合并冠心病对患者外周胰岛素抵抗、糖化血红蛋白、脂蛋白和心肌缺血的影响[J].陕西医学杂志,2022,51(5):595.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.019]
 WANG Jing,LIU Yiting,LIU Zhe.Effects of telmisartan combined with rosuvastatin on peripheral insulin resistance,glycosylated hemoglobin,lipoproteins and myocardial ischemia in diabetic patients with coronary heart disease[J].,2022,51(4):595.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.019]

备注/Memo

备注/Memo:
基金项目:河北省卫生健康委员会重点科技研究计划项目(20200426); 河北省邯郸市科学技术研究与发展计划项目(1823208085ZC)
更新日期/Last Update: 2024-04-07