Verma Shashwat, Sathyamurthy I, Shelley S, Indirani M, Pawaskar Alok S, Jayanthi K, Ramachandran P
Department of Nuclear Medicine, Apollo Hospital, Chennai 600006.
Department of Cardiology, Apollo Hospital, Chennai 600006.
J Assoc Physicians India. 2013 Apr;61(4):250-4.
To identify coronary artery disease (CAD) in asymptomatic diabetics with the help of myocardial perfusion single photon emission computed tomography (MPS), a non-invasive imaging modality and its correlation in diabetics with or without microalbuminuria.
This study included 99 patients in the age group of 30 to 80 years who were asymptomatic but possessed one or more risk factors for CAD. These patients were divided into two groups, diabetics with and without microalbuminuria (Micral). Thirty eight patients were Micral positive and 61 were Micral negative. Ischemia was detected by MPS and compared with coronary angiographic findings in both the groups.
Amongst the 99 diabetic patients, MPS was positive in 39 patients. Out of 39 MPS positive patients, 31(79.5%) were micral positive and 8 (20.5%) were micral negative. Out of 38 micral positive patients, 31 patients were positive on MPS and 27 had significant angiographic (CAG) findings. Those with micral positive and MPS positive had multivessel CAD by CAG. It was seen that MPS status was 91.4% sensitive, 74.1% specific and had 82.1% positive predictive values (PPV) and 87.0% negative predictive value (NPV) for detection of significant CAD.
Microalbuminuria is an inexpensive screening tool and a powerful independent predictor for major cardiovascular events in patients with type 2 diabetes mellitus. MPS is a sensitive, non invasive diagnostic test for identification of CAD in asymptomatic diabetic patients.
借助心肌灌注单光子发射计算机断层扫描（MPS）这一无创成像方式，识别无症状糖尿病患者的冠状动脉疾病（CAD），并研究其在有或无微白蛋白尿的糖尿病患者中的相关性。
本研究纳入了99名年龄在30至80岁之间、无症状但具有一项或多项CAD危险因素的患者。这些患者被分为两组，即有和无微白蛋白尿（Micral）的糖尿病患者。38名患者Micral阳性，61名患者Micral阴性。通过MPS检测缺血情况，并与两组的冠状动脉造影结果进行比较。
在99名糖尿病患者中，39名患者MPS呈阳性。在39名MPS阳性患者中，31名（79.5%）Micral阳性，8名（20.5%）Micral阴性。在38名Micral阳性患者中，31名患者MPS阳性，27名有显著的血管造影（CAG）结果。Micral阳性且MPS阳性的患者经CAG显示有多支血管CAD。结果显示，MPS状态在检测显著CAD方面的敏感性为91.4%，特异性为74.1%，阳性预测值（PPV）为82.1%，阴性预测值（NPV）为87.0%。
微量白蛋白尿是一种廉价的筛查工具，也是2型糖尿病患者主要心血管事件的有力独立预测指标。MPS是一种用于识别无症状糖尿病患者CAD的敏感、无创诊断测试。
