应力心肌灌注成像在印度糖尿病患者中的诊断准确性：单中心经验

Diagnostic Accuracy of Stress Myocardial Perfusion Imaging in Indian Diabetic Patients: A Single Centre Experience.

作者信息

Kumar Deepa, Sethi Ravinder Singh, Bansal Sandeep, Namgyal Padma A, Sehgal Aditi Khurana, Malik Tajamul Syed

机构信息

Department of Nuclear Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

Department of Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

出版信息

Indian J Nucl Med. 2017 Jul-Sep;32(3):177-183. doi: 10.4103/0972-3919.207873.

DOI:10.4103/0972-3919.207873

PMID:28680199

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5482011/

Abstract

UNLABELLED

Diabetics have around 2-4 times increased risk of coronary artery disease(CAD) and it is the most important cause of mortality in these patients. This study was carried out to compare the sensitivity, specificity and accuracy of MPI-SPECT among diabetics and non-diabetics in the Indian population.

MATERIAL AND METHODS

This retrospective study included 261 patients; 213 males and 48 females, with 75 diabetic and 186 non-diabetic patients. Only type II diabetics and non-diabetic patients were included in the study. Only patients who had coronary angiography (CAG) done within 6 months of the stress Tc-sestamibi MPI-SPECT study were included in the study. Two arbitrary cut off points on CAG ≥ 50% and ≥ 70% were used for determination of extent of CAD.

RESULTS

Considering coronary angiography as gold standard with ≥ 50% coronary stenosis as a cut off criteria for significant stenosis the sensitivity and specificity respectively, of myocardial perfusion SPECT was 83% and 72% in diabetics and 81% and 69% in non-diabetic pateints ( value not significant). For ≥ 70% coronary stenosis as a cut off criteria for significant stenosis the sensitivity and specificity respectively, of myocardial perfusion SPECT was 87% and 61% in diabetics and 88% and 58%in non-diabetics ( value not significant). No significant difference was found in the sensitivity, specificity and accuracy of LAD, LCx and RCA coronary vessels among diabetics and non-diabetics for both ≥ 50% and ≥ 70% coronary stenosis as cut off criteria. Diabetic patients had a lower incidence of SVD compared to the non-diabetic patients. They also had a higher incidence of TVD and MVD compared to the non-diabetic patients with both ≥ 50% and ≥ 70% diameter stenosis criteria ( value significant).

CONCLUSION

Sensitivity and specificity of Tc-sestamibi myocardial perfusion imaging is similar in diabetic and non-diabetic patients in Indian population.

摘要

未标记

糖尿病患者患冠状动脉疾病（CAD）的风险增加约2至4倍，这是这些患者死亡的最重要原因。本研究旨在比较印度人群中糖尿病患者和非糖尿病患者MPI-SPECT的敏感性、特异性和准确性。

材料与方法

这项回顾性研究纳入了261例患者；213例男性和48例女性，其中75例糖尿病患者和186例非糖尿病患者。本研究仅纳入II型糖尿病患者和非糖尿病患者。仅纳入在负荷Tc-司他米比MPI-SPECT研究后6个月内进行冠状动脉造影（CAG）的患者。CAG上两个任意的截断点≥50%和≥70%用于确定CAD的程度。

结果

以冠状动脉造影为金标准，以≥50%冠状动脉狭窄作为显著狭窄的截断标准，心肌灌注SPECT在糖尿病患者中的敏感性和特异性分别为83%和72%，在非糖尿病患者中分别为81%和69%（p值无显著性差异）。以≥70%冠状动脉狭窄作为显著狭窄的截断标准，心肌灌注SPECT在糖尿病患者中的敏感性和特异性分别为87%和61%，在非糖尿病患者中分别为88%和58%（p值无显著性差异）。对于≥50%和≥70%冠状动脉狭窄作为截断标准，糖尿病患者和非糖尿病患者在左前降支、左旋支和右冠状动脉的敏感性、特异性和准确性方面均未发现显著差异。与非糖尿病患者相比，糖尿病患者单支血管病变的发生率较低。在直径狭窄标准≥50%和≥70%时，与非糖尿病患者相比，他们多支血管病变和心肌微血管病变的发生率也更高（p值有显著性差异）。