摘要
目的 探讨慢型克山病患者心脏正电子发射断层显像/X线计算机体层成像仪（PET/CT）检查评分与慢性心力衰竭标志等生化指标间的关系.方法 在克山病病区确诊的以往病例中,选取15例慢型克山病患者进行心脏PET/CT检查和心脏超声,PET/CT检查左心室17个节段并进行评分.评分标准：轻度0～17分、中度18～ 34分、重度35～ 51分.采集全部患者静脉血,进行血清慢性心力衰竭标志等生化指标的测定,包括N末端B型利钠肽原（NT-ProBNP）、脑钠肽（BNP）、心肌肌钙蛋白Ⅰ（cTnⅠ）、基质金属蛋白酶1（MMP1）、基质金属蛋白酶抑制剂（TIMP1）、超氧化物歧化酶（SOD）、丙二醛（MDA）、血管紧张素Ⅱ（AngⅡ）和骨桥蛋白（OPN）.AngⅡ测定采用放射免疫法（RIA）,SOD、MDA测定采用比色法,其他测定采用酶联免疫吸附试验（ELISA）.将PET/CT检查评分总分与慢性心力衰竭标志等生化指标进行Spearman相关分析.结果 15例患者心脏PET/CT检查均显示有不同程度的摄取降低,各节段评分总分最小者为9分,最大者为38分,平均为（23±9）分.相关分析显示,患者心脏PET/CT检查评分与cTnⅠ和NT-ProBNP的相关性有统计学意义（r=0.714、0.684,P均＜ 0.01）,与BNP、MMP1、TIMP1、MDA、SOD、AngⅡ、OPN的相关性无统计学意义（r=1.000、0.948、0.749、0.620、0.428、0.685、0.094,P均＞0.05）.患者心脏PET/CT检查评分与心脏超声检查的一致性较高.结论 慢型克山病患者心脏PET/CT检查左心室各节段评分对判断患者慢性心力衰竭有一定的参考价值.
Objective To explore the relationship between chronic Keshan disease cardiac PET/CT score and the markers of heart failure and cardiac remodeling.Methods Totally 15 old cases of Keshan disease patients from previous studies were examined with cardiac echocardiography and PET/CT.The score of the intake decrease of the 17 segments of the left ventricle was divided into three categories （mild：0-17; moderate：18-34; severe：35-51）; the levels of serum N-terminal B-type natriuretic peptide prosema（NT-ProBNP）,B-type natriuretic peptide （BNP）,cardiac troponin Ⅰ （cTnⅠ）,matrix metalloproteinase 1 （MMP1）,matrix metallo-proteinase inhibitor （TIMP1）,superoxide dismutase （SOD）,malondialdehyde（MDA）,angiotensin Ⅱ （Ang Ⅱ） and osteopontin （OPN） were measured,and correlation analysis between cardiac PET/CT scores of the patients and the biomarkers was conducted.Results All the 15 patients showed different degrees of reduced intakes,the mean of the total PET/CT score was 23 ± 9,the minimum was 9,and the maximum was 38.Spearman correlation analysis showed that cardiac PET/CT scores were statistically significantly correlated with cTnⅠ and NT-ProBNP （r =0.714,0.684,all P 〈 0.01）,and were not statistically correlated with BNP,MMP1,TIMP1,MDA,SOD,AngⅡ and OPN （r =1.000,0.948,0.749,0.620,0.428,0.685,0.094,all P 〉 0.05）.The cardiac PET/CT scores of the patients were in good consistency with the results of cardiac ultrasound examination.Conclusion The cardiac PET/CT score of the patients with chronic Keshan disease may have important reference value in evaluating heart failure and cardiac remodeling of the patients.
出处
《中华地方病学杂志》
CAS
CSCD
北大核心
2015年第4期303-305,共3页
Chinese Journal of Endemiology
基金
国家自然基金项目（81372938、81202154、81172607）
黑龙江省卫生厅科研课题（2009-011）
关键词
慢型克山病
正电子发射断层显像术
利钠肽
脑
Chronic Keshan disease
Positron-Emission tomography
Natriuretic Peptide, Brain
