慢型克山病心脏单光子发射型计算机断层显像评分与心力衰竭标志物的关系  

The relationship between cardiac single-photon emission computed tomography imaging score of chronic Keshan disease and the biomarkers of heart failure

作　　者：庞宏洋[1] 金刚[2] 王铜[1] 刘玉婷[2] 王 徐伯楠[1] 刘红[1] 高祥芝 吴欢[1] 李世娥[1] 于丽娟 李迎辞 

机构地区：[1]哈尔滨医科大学中国疾病预防控制中心地方病控制中心克山病防治研究所,150081 [2]哈尔滨医科大学附属第二医院,150081 [3]附属肿瘤医院PElI/CT-MRI中心

出　　处：《中华地方病学杂志》2015年第6期393-396,共4页Chinese Journal of Endemiology

基　　金：国家自然科学基金

摘　　要：目的 探讨慢型克山病患者心脏单光子发射型计算机断层显像（single-photon emission computed tomography,SPECT）特征与心力衰竭标志物之间的关系.方法 对21例慢型克山病患者进行99m锝-甲氧基异丁基异腈（99mTc-MIBI） SPECT检查,获得20节段模型心肌灌注图像,计算各节段评分;采用酶联免疫吸附法、比色法测定患者血液中N末端B型利钠肽原（NT-ProBNP）、脑钠肽（BNP）、心肌肌钙蛋白I（cTnI）、骨桥蛋白（OPN）、基质金属蛋白酶（MMP）1、基质金属蛋白酶抑制剂（TIMP）1、可溶性生长刺激表达因子2蛋白（sST2）、丙二醛（MDA）、超氧化物歧化酶（SOD）,并与SPECT评分进行Spearman相关分析.结果 克山病患者心尖、近心尖部、心中部、基底部四级评分分别为（0.93±0.03）、（0.73±0.34）、（0.97±0.24）、（1.67±0.23）分,20节段平均为（1.10±0.46）分;二分类评分分别为（0.83±0.03）、（0.65±0.25）、（0.83±0.16）、（1.00±0.00）分,20节段平均为（0.83±0.21）分;SPECT总评分与cTnI、OPN的相关系数分别为-0.467、-0.502（P均＜0.05）.结论 慢型克山病患者心脏SPECT显像可以发现患者心脏摄取减低及分布,SPECT评分对患者慢性心力衰竭和预后有一定参考价值.Objectives To explore the relationship between cardiac single-photon emission computed tomography （SPECT） imaging score of patients with chronic Keshan disease and the markers of heart failure.Methods Twenty-one Keshan disease patients were examined with 99mTc-MIBI SPECT and myocardial images were scored with 20-segment model.The N-terminal pro-B-type natriuretic peptide （NT-ProBNP）,brain natriuretic peptide （BNP）,cardiac troponin I （cTnI）,osteopontin （OPN）,matrix metalloproteinase 1 （MMP1）,tissue inhibitor of metalloproteinases （TIMP1）,soluble growth stimulating express gene 2 （sST2）,malondialdehyde （MDA）,superoxide dismutase （SOD） were measured with ELISA and colorimetry.Spearman correlation was conducted between cardiac SPECT image scores and the biomarkers.Results The four-category scores of apex,distal,mid and base were 0.93 ± 0.03,0.73 ± 0.34,0.97 ± 0.24 and 1.67 ± 0.23,and the average score of 20 segments was 1.10 ± 0.46;the two-category scores of apex,distal,mid and base were 0.83 ± 0.03,0.65 ± 0.25,0.83 ± 0.16 and 1.00 ± 0.00,and the average score of 20 segments was 0.83 ± 0.21.Spearman correlation analysis showed that SPECT binary scores were statistically correlated with cTnl （r =-0.467,P 〈 0.05） and OPN （r =-0.502,P 〈 0.05）.Conclusion The cardiac SPECT image of the patients with chronic Keshan disease may have reference value in evaluating heart failure and cardiac remodeling of the patients.

关 键 词：慢型克山病 单光子发射型计算机断层像 心力衰竭 心肌损伤 标志物 

分 类 号：R542.3[医药卫生—心血管疾病] R816.2[医药卫生—内科学] R541.6[医药卫生—临床医学]