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The purpose of an application of 99m Tc - methoxy isobutyl isonitrile (99mTc-MIBI) single photon emission computed tomography (SPECT) myocardial perfusion imaging comparative analysis of elderly patients with coronary heart disease (CHD) and CHD patients with type 2 diabetes (T2DM) and / myocardial ischemia in patients with essential hypertension (EH), the differences in heart function, and the groups were compared serum markers of difference; explore the degree of myocardial ischemia on ventricular function and heart rate variability. SPECT evaluation qumei-improvement of myocardial ischemia and cardiac function in patients with coronary heart disease. Method 1. Collected from 2006-12 to 2009-06 in the hospital outpatient and inpatient clinical data of 178 cases of elderly patients with CHD, parallel-gated SPECT myocardial perfusion scintigraphy, divided into four groups according to the disease: CHD group alone, the combined T2DM group, the combined EH group, merged T2DM and EH group. Statistics four groups total load score (SSS), the total rest score (SRS), and the total difference (SDS), left ventricular ejection fraction (LVEF) and serological indicators on the four sets of data were analyzed ; collect clinical data of 36 cases of myocardial perfusion imaging with normal over the same period, according to the the SPECT result of re-divided into three groups, group A: no perfusion defect group, group B: fully reversible perfusion defects in group C group: not fully reversible perfusion defect group and by Doppler two-dimensional ultrasound evaluation of cardiac function parameters. 2 randomly selected order of admission SPECT detected 30 cases of myocardial ischemia in patients with coronary heart disease, given trimetazidine 20mg orally three times a day, 6-month follow-up after the review of myocardial perfusion imaging. Evaluation after treatment of myocardial perfusion, cardiac function improvement. Results 1 (1) combined T2DM group, the combined EH group, merged T2DM and EH group radionuclide myocardial perfusion imaging SSS, SDS and D-dimer (DD), von Willebrand factor (vWF), high-sensitivity C-reactive protein (hs-CRP) were higher than those of CHD group (p lt; 0.05), but the LVEF significantly less than the simple CHD group (p lt; 0.05); merger T2DM and EH group SSS, SDS and DD, vWF, hs-CRP were higher than the combined T2DM group alone or combined EH group, EF was significantly lower (p lt; 0.05); combined T2DM group, the combined EH group between the two groups no significant difference (p = 0.34); among the four groups lipids without significant difference. Multivariate analysis showed DD, vWF, hs-CRP level and SSS, SDS positive correlation. ② B group, C group end-systolic volume (ESV), end-diastolic volume (EDV), left ventricular ejection fraction (LVEF) was significantly higher than that in group A, C group and B group, ESV, EDV was no statistically significant difference, C than in group B group LVEF decreased significantly (p lt; 0.05); standard deviation of B group, C group RR interval (SDNN), the mean standard deviation of 5-minute segment of the average normal RR interval index (SDANN Index), 5 min RR between mean standard deviation index (SDNN Index) of RR interval difference is the square root (rMSDD), two adjacent RR interval difference is greater than 50ms cardiac accounted for the analysis of cardiac percentage of the total number (PNN50 significantly lower) than group A (p lt; 0.05); each group of data between the C group and B group there was no statistically significant difference (p gt; 0.05). Fault gated imaging obtained ESV and EDV, LVEF value echocardiography showed no significant statistical difference, with a good correlation. Trimetazidine triazine test compared with before the test, SSS, SDS decreased, LVEF increased P lt; 0.05. SRS was no significant difference in conclusions. Radionuclide myocardial perfusion imaging can effectively evaluate coronary myocardial blood supply; CHD combined T2DM or EH myocardial ischemia in patients with significant poor heart function; combining T2DM and EH myocardial ischemia in patients with the most severe, and heart function worse; DD, vWF and hs-CRP levels may reflect the extent of myocardial ischemia; degree of myocardial ischemia and heart function and heart rate variability, myocardial ischemia more serious, the more obvious heart function and reduce heart rate variability; fault gated imaging and echocardiography has a good correlation. 2 trimetazidine can effectively improve myocardial perfusion and cardiac function in elderly patients with coronary heart disease.
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