摘要目的 探讨[二(二甲氧丙基膦基乙基)-乙氧乙胺]-[二(氧-乙氧乙基)二硫代氨基]锝氮配合物(99Tcm-N-DBODC5)对可疑冠心病患者的临床诊断价值.方法 将2010年10月至2012年10月间46例可疑冠心病患者[男31例,女15例,平均年龄60岁]按就诊先后顺序编号,同一患者随机分配进行99Tcm-N-DBODC5和99Tcm-MIBI运动-静息MPI检测冠心病及病变血管,2种显像剂的MPI在1周内完成,并在4周内行CAG.以CAG结果为“金标准”,99Tcm-N-DBODC5和99Tcm-MIBIMPI结果分别与其进行一致性检验,不同显像剂诊断效能的比较行x2检验.结果 46例可疑冠心病患者中,CAG阳性29例,阴性17例.99Tcm-N-DBODC5和99Tcm-MIBI MPI诊断冠心病的灵敏度均为86％ (25/29),特异性分别为88％(15/17)和65％(11/17),两者诊断冠心病效能差异无统计学意义(x2=2.62,P＞0.05);138支冠状动脉血管中,CAG阳性48支,阴性90支.99Tcm-N-NDBODC5与99Tcm-MIBI MPI诊断病变血管效能差异也无统计学意义(x2=3.79,P＞0.05).诊断冠心病方面,99Tcm-N-DBODC5 MPI与CAG结果的一致性较好(Kappa=0.73),99Tcm-MIBI MPI与CAG结果的一致性中等(Kappa=0.52).结论 99Tcm-N-DBODC5对冠心病患者具有一定诊断价值,可作为心肌灌注显像剂应用于临床.

abstractsObjective To investigate the clinical value of 99Tcm-(bis(dimethoxypropylphosphinoethyl)-ethoxyethylamine)-(bis(N-ethoxyethyl)-dithiocarbamato nitride (99Tcm-N-DBODC5) for the detection of coronary artery disease (CAD).Methods From October 2010 to October 2012,46 patients with suspected CAD (31 males,15 females; average age:60 years) were recruited.They all underwent stressrest MPI using both 99Tcm-N-DBODC5 and 99Tcm-MIBI within l week.CAG was carried out within 1 month after MPI and chosen as the gold standard.The diagnostic accordance rate between MPI and CAG were analyzed using Kappa test.The diagnostic efficiency of 99Tcm-N-DBODC5 and 99Tcm-MIBI MPI was compared byx2 test.Results Among the 46 patients,29 were positive and 17 were negative for CAD by CAG.The sensitivity and specificity in the detection of CAD were 86％ (25/29) and 65％ (11/17) for 99Tcm-MIBI MPI,86％ (25/29) and 88％ (15/17) for 99Tcm-N-DBODC5 MPI (x2=2.62,P＞0.05),respectively.Among the 138 vessels,48 were positive and 90 were negative on CAG.The vessel-based sensitivity,specificity and accuracy for the detection of stenosis were not significantly different between 99Tcm-N-DBODC5 and 99Tcm-MIBI (x2=3.79,all P＞0.05).The accordance between 99Tcm-N-DBODC5 MPI and angiography was very good (Kappa=0.73) and moderate for 99Tcm-MIBI MPI (Kappa=0.52).Conclusion 99Tcm-N-DBODC5 might have a potential role as a MPI agent for the diagnosis of CAD.