锝-99m 替曲膦单光子发射计算机断层显像中反向再分布的临床意义：一项 18 个月的随访研究
Clinical significance of reverse redistribution on technetium-99m tetrofosmin single-photon emission computed tomography: an 18-month follow-up study.
作者信息
Swinkels B M, Hooghoudt T E H, Schoenmakers E A J M, Zinder C G, de Boo T M, Verheugt F W A
出版信息
Neth Heart J. 2003 Mar;11(3):113-117.
BACKGROUND
The clinical and prognostic significance of reverse redistribution on technetium-99m (Tc) single-photon emission computed tomography (SPECT) is unclear.
OBJECTIVES
To determine outcomes of chest pain patients showing reverse redistribution after Tc tetrofosmin SPECT versus SPECT showing no reverse redistribution.
METHODS
Patient outcomes (death, nonfatal myocardial infarction, coronary artery bypass grafting and percutaneous transluminal coronary angioplasty) within 18 months after Tc tetrofosmin SPECT were determined in two populations of ambulatory patients, most of whom had been evaluated because of chest pain: a population of 57 patients whose SPECT images showed reverse redistribution without reversible or fixed defects, versus a control population of 98 patients whose SPECT images were normal (no reverse redistribution, no reversible defects, no fixed defects).
RESULTS
Stepwise logistic regression analysis showed that the population of patients with reverse redistribution did not have a worse 18-month outcome in comparison with the control population of patients without reverse redistribution (3.5% versus 9.2%, respectively; p=0.15 corrected for age and gender).
CONCLUSION
Reverse redistribution on Tc tetrofosmin SPECT does not appear to be an unfavourable prognostic factor in ambulatory chest pain patients.
背景
锝-99m（Tc）单光子发射计算机断层扫描（SPECT）上反向再分布的临床及预后意义尚不清楚。
目的
确定锝替曲膦SPECT检查后出现反向再分布的胸痛患者与未出现反向再分布的SPECT检查患者的预后情况。
方法
在两组门诊患者中确定锝替曲膦SPECT检查后18个月内的患者预后（死亡、非致命性心肌梗死、冠状动脉旁路移植术和经皮腔内冠状动脉成形术），这些患者大多因胸痛接受评估：一组57例患者，其SPECT图像显示反向再分布但无可逆或固定缺损；另一组为98例对照患者，其SPECT图像正常（无反向再分布、无可逆缺损、无固定缺损）。
结果
逐步逻辑回归分析显示，与无反向再分布的对照患者群体相比，出现反向再分布的患者群体18个月的预后并无更差（分别为3.5%和9.2%；校正年龄和性别后p=0.15）。
结论
锝替曲膦SPECT上的反向再分布似乎并非门诊胸痛患者的不良预后因素。
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