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首页> 外文期刊>Journal of cardiology >Usefulness of technetium-99m tetrofosmin single-photon emission computed tomography for short-term risk stratification in patients with acute chest pain in the emergency room
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Usefulness of technetium-99m tetrofosmin single-photon emission computed tomography for short-term risk stratification in patients with acute chest pain in the emergency room

机译：m 99m trofofomin单光子发射计算机断层扫描对急诊室急性胸痛患者的短期危险分层的有用性

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OBJECTIVES: High-risk patients with acute coronary syndrome are difficult to distinguish from low-risk patients with chest pain in the emergency room. Technetium-99m (99mTc) tetrofosmin single-photon emission computed tomography (SPECT) was investigated to exclude high-risk patients with chest pain in the emergency room. METHODS: 99mTc-tetrofosmin SPECT was evaluated using a four-point scoring system in 228 patients (144 men, 84 women, mean age 68 +/- 12 years) with chest pain. Negative was defined as the myocardial segments with a defect score (DS) of < 2. The patients were divided into two groups; the negative group with DS < 2 (n = 78) and the positive group with DS > or = 2 (n = 150). Cardiac events (cardiac death, acute myocardial infarction and refractory angina) were evaluated within 30 days of onset. ST-segment elevation or depression > or = 0.1 mV was defined as positive in electrocardiography. The results of SPECT were compared with those of electrocardiography, transthoracic echocardiographyand serum cardiac markers (troponin T and creatine kinase-MB) in 95 patients. RESULTS: The negative group had very few cardiac events (three patients with refractory angina) (3.8%). The negative predictive value of cardiac events evaluated by electrocardiography was calculated as 83.1%, whereas the negative predictive value by SPECT was 96.2% (p < 0.01). In addition, the negative predictive value of acute myocardial infarction by SPECT was 100%. The negative predictive values of cardiac events evaluated by SPECT, electrocardiography, transthoracic echocardiography and serum cardiac markers were 95.8%, 81.5% (vs 99mTc-tetrofosmin; NS), 84.9% (NS) and 60.4% (p < 0.05), respectively. CONCLUSIONS: 99mTc-tetrofosmin SPECT is a useful method to exclude high-risk patients among patients with chest pain in the emergency room.
机译：目的：在急诊室很难将高风险的急性冠状动脉综合征患者与低风险的胸痛患者区分开。对Technetium-99m（99mTc）替罗福明单光子发射计算机断层扫描（SPECT）进行了研究，以排除急诊室有胸痛的高危患者。方法：采用四点评分系统对228例胸痛患者（男性144例，女性84例，平均年龄68 +/- 12岁）进行99mTc-四磷酸磷素SPECT评估。阴性定义为缺损评分（DS）小于2的心肌节段。 DS <2的阴性组（n = 78）和DS>或= 2的阳性组（n = 150）。在发病后30天内评估心脏事件（心脏死亡，急性心肌梗塞和难治性心绞痛）。心电图中ST段抬高或压低>或= 0.1 mV被定义为阳性。将95例患者的SPECT结果与心电图，经胸超声心动图和血清心脏标志物（肌钙蛋白T和肌酸激酶-MB）进行比较。结果：阴性组的心脏事件极少（3例难治性心绞痛患者）（3.8％）。心电图评估的心脏事件的阴性预测值为83.1％，而SPECT的阴性预测值为96.2％（p <0.01）。此外，SPECT对急性心肌梗死的阴性预测值为100％。通过SPECT，心电图，经胸超声心动图和血清心脏标志物评估的心脏事件的阴性预测值分别为95.8％，81.5％（vs 99mTc-tetrofosmin; NS），84.9％（NS）和60.4％（p <0.05）。结论：99mTc-tetrofosmin SPECT是排除急诊室胸痛患者中高危患者的有用方法。

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