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[三磷酸腺苷二钠静脉注射药物负荷心肌铊显像在冠心病诊断中的准确性及副作用]

[The accuracy and side effects of pharmacologic stress thallium myocardial scintigraphy with adenosine triphosphate disodium (ATP) infusion in the diagnosis of coronary artery disease].

作者信息

Kinoshita S, Suzuki S, Shindou A, Watanabe K, Muramatsu T, Ide M, Dohi Y, Yamashita S, Suzuki T, Nishimura K

机构信息

Second Department of Internal Medicine, Saitama Medical School.

出版信息

Kaku Igaku. 1994 Aug;31(8):935-41.

PMID:7933682
Abstract

The diagnostic accuracy and side effects of pharmacologic stress thallium myocardial scintigraphy with ATP infusion were studied in 172 patients with or without coronary artery disease. ATP was infused for five minutes at a rate of 0.16 mg/kg/min (group A) or 0.18 mg/kg/min (group B) via antecubital vein. One hundred and eleven (67 of group A, 44 of group B) of 172 patients underwent coronary arteriography (CAG). In 111 patients received CAG, overall sensitivity, specificity and accuracy of this method were 88%, 84% and 87%, respectively. In 67 patients of group A, these were 92%, 81% and 90%. In 44 patients of group B, 79%, 87% and 82% were documented (NS, between group A and B). Chest pain, flushing, bradycardia and ST depression were included in side effects caused by ATP infusion. At least one of these side effects were observed in 84% of the all 172 patients, 89% of group A and 75% of group B (NS). But, all of the side effects were spontaneously alleviated within two minutes without any therapy. In conclusion, pharmacologic stress myocardial scintigraphy with ATP infusion is very accurate and safe, and infusion rate of 0.16 mg/kg/min is optimal for this purpose.

摘要

对172例有无冠状动脉疾病的患者研究了静脉输注三磷酸腺苷(ATP)行药物负荷心肌铊闪烁扫描的诊断准确性及副作用。通过肘前静脉以0.16mg/kg/min的速率(A组)或0.18mg/kg/min的速率(B组)输注ATP 5分钟。172例患者中有111例(A组67例,B组44例)接受了冠状动脉造影(CAG)。在接受CAG的111例患者中,该方法的总体敏感性、特异性和准确性分别为88%、84%和87%。在A组的67例患者中,分别为92%、81%和90%。在B组的44例患者中,分别为79%、87%和82%(A组和B组之间无显著性差异)。胸痛、面部潮红、心动过缓和ST段压低均为ATP输注引起的副作用。在全部172例患者中有84%观察到至少一种上述副作用,A组为89%,B组为75%(无显著性差异)。但所有副作用在未进行任何治疗的情况下于2分钟内自行缓解。结论:静脉输注ATP行药物负荷心肌闪烁扫描非常准确且安全,为此目的0.16mg/kg/min的输注速率最为适宜。

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