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锝-99m sestamibi心肌灌注成像肺心比增高与多支血管冠状动脉疾病之间的临床关系

世界核心医学期刊文摘（心脏病学分册） 2005年第10期1卷 50-51页

作者： Kumar S. P. Brewington S. D. O' Brien K. F. Movahed A. 刘健 Section of Cardiology Department of Internal Medicine E. Carolina Univ. Brody Sch. of Med. Greenville NC 27858- 4354 United States

An increased lung to heart ratio(LHR) on thallium-201(Tl- 201) stress myocardial perfusion imaging(MPI) is a predictor of adverse cardiac events and identifies people with extensive coronary artery disease(CAD). The implications of increased LHR in patients undergoing stress technetium- 99m(tc- 99m) sestamibi are developing. Our aim is to evaluate the relationship between increased LHR and extent of CAD in patients undergoing tc- 99m sestamibi MPI. Methods: We reviewed the records and images of 530 consecutive subjects who underwent exercise or adenosine tc- 99 m sestamibi MPI. One hundred thirty-two had transient or partially reversible myocardial perfusion defects and 79(exercise=34, adenosine=45, male=43, female=36, mean age=61 years) of these underwent coronary angiography(study population). The average LHR of these 79 subjects was compared to 79 patients(control population) with normal scans(exercise=50, adenosine=29, male=34, female=45, mean age=60 years). Results: The mean LHR(± SE) in subjects with normal scans was 0.30± 0.01. The mean LHR for those with abnormal scans and single vessel CAD who underwent exercise was 0.32± 0.01 and pharmacological stress was 0.31± 0.01. There was no statistically significant difference between the LHR of those with a normal scan and those with single vessel disease and an abnormal scan. However, there was a statistically significant association between the elevated LHR and multi-vessel CAD. The mean LHR for subjects with multi-vessel CAD with exercise was 0.39± 0.01(p=0.000) and for adenosine was 0.39± 0.02(p=0.000). Conclusion: An elevated LHR in patients undergoing exercise or pharmacological tc- 99m MPI correlates with multi-vessel CAD.

关键词：支血管 m sestamibi 临床关系灌注成像不良心脏事件受试组血管病图像资料

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采用sestamibi负荷踏车试验检测有或无糖尿病患者中未识别心肌梗死和无症状心肌缺血的患病率

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世界核心医学期刊文摘（心脏病学分册） 2007年第3期3卷 35-36页

作者： DeLuca A.J. Kaplan S. Aronow W.S. 杜媛 Dr. Department of Medicine Cardiology Division New York Medical College Valhalla NY United States

通过sestamibi负荷踏车试验,观察了287例糖尿病患者(71%为男性,平均年龄63±8岁)和292例年龄及性别与之匹配的非糖尿病患者中未识别心肌梗死(MI)和无症状心肌缺血(SMI)的患病率。

关键词：踏车试验 sestamibi 无症状心肌缺血心绞痛病史

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Lithium Associated Hyperparathyroidism: An Evidence Based Surgical Approach

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Surgical Science 2011年第10期2卷 468-475页

作者： Umashankar K Ballehaninna Steven M. Nguyen Ronald S. Chamberlain 不详

Background: Long-term lithium use in psychiatric patients may lead to lithium associated hyperparathyroidism (LAH). Although anecdotal case reports have appeared, an evidence based algorithm for management of LAH is lacking. Methods: A comprehensive literature search was performed (1973-2010) using PubMed with keywords;“lithium” “hypercalcemia” “hyperparathyroidism” “sestamibi” “intra-operative parathyroid hormone (IOPTH) monitoring” “parathyroidectomy” and “medical management”. All English language publications addressing etiology and clinical management issues concerning LAH were critically analyzed. Results: Lithium associated hyperparathyroidism occurs in 4.3% - 6.3% of chronic lithium users compared to the general population which has an incidence of 0.5% - 1%. 194 cases of LAH have been reported which includes 10 patients (5%) treated medically and 170 patients (88%) who underwent parathyroidectomy. No details were available for 14 patients (7%). Among parathyroidectomy patients, 104 (59%) had adenomatous disease and 66 (39%) had multiglandular hyperplasia. Preoperative localization studies were utilized in only 22 patients (13%) and IOPTH monitoring was reported in only 3 studies (32 patients, 19%). Among surgical patients, bilateral neck exploration (BNE) was the most common approach performed in 162 patients (95%);focused neck exploration was utilized in only 8 patients (5%). Parathyroidectomy normalized LAH biochemical changes in nearly all patients (90% - 97%) in the early post-operative period, but recurrent hyperparathyroidism occurred in 8% - 42% of patients. Conclusion: LAH is an under appreciated and poorly understood endocrine disorder. LAH has a higher incidence of multiglandular disease and bilateral neck exploration is mandatory in majority for disease control. Nonsurgical approaches may be useful in select patients on short-term lithium therapy.

关键词： Lithium Hypercalcemia Hyperparathyroidism sestamibi Intra-Operative Parathyroid Hormone (IOPTH) Monitoring Parathyroidectomy Medical Management

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因胸痛来急诊室就诊但心电图不能作诊断的病人进行99m锝-sestamibi显像以除外急性心肌缺血

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国际心血管病杂志 1994年第4期 255-255页

作者：芮涛

方法入选条件:男>25岁,女>40岁,胸痛持续时间≥30min,急诊时距胸痛开始不超过12h,ECG无特征性改变,症状不能以心外因素解释。凡陈旧性心肌梗塞的

关键词：胸痛 sestamibi 疼痛急诊室急性心肌缺血

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