潜在型克山病心脏单光子发射型计算机断层显像评分与心脏生物标志物及超声指标的关系  

The relationship between cardiac single-photon emission computed tomography imaging scores of latent Keshan disease and the parameters of cardiac biomarkers and echocardiography

作　　者：高祥芝 金刚[2] 王铜[1] 刘玉婷[2] 徐伯楠[1] 刘红[1] 庞宏洋[1] 吴欢[1] 于丽娟[4] 李迎辞[4] 刘白鹭[3] 

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,哈尔滨150081 [2]哈尔滨医科大学附属第二医院核医学科,哈尔滨150086 [3]哈尔滨医科大学附属第二医院CT室,哈尔滨150086 [4]哈尔滨医科大学附属肿瘤医院PET/CT—MRI中心,哈尔滨150001

出　　处：《中华地方病学杂志》2016年第7期493-497,共5页Chinese Journal of Endemiology

基　　金：国家自然科学基金（81372938、81172607）

摘　　要：目的探讨潜在型克山病（LKD）患者心脏单光子发射型计算机断层显像（SPECT）特征与心脏生物标志物及超声指标的关系。方法对10例LKD患者进行99m锝．甲氧基异丁基乙腈（^99mTc—MIBI）SPECT和心脏超声检查，SPECT检查获得20节段模型心肌灌注图像，计算各节段四等级、二分类总评分。采用比色法、酶联免疫吸附法测定患者血液中超氧化物歧化酶（SOD）、丙二醛（MDA）、心肌肌钙蛋白I（cTnI）。SPECT总评分和各指标的相关性采用Spearman分析。结果所有患者心脏SPECT检查均显示有不同程度的示踪剂摄取降低。相关分析显示，SPECT四等级总评分范围为11—24分，平均（17±4）分；二分类总评分范围为9—17分，平均（13±2）分。SPECT四等级、二分类总评分与SOD、MDA、cTnI无相关性（r=-0．35、0．25、0．27、0．00、0．34、0．08，P均〉0．05）。SPECT四等级总评分与左室舒张末容积（LVEDV）、心脏质量（LVM）相关性比较有统计学意义（r=0．71、0．77，P均〈0．05），二分类总评分与舒张末左室后壁厚度（LVPWT）、心排出量（CO）、LVEDV、左室收缩末容积（LVESV）、LVM相关性比较有统计学意义（r=0．81、0．75、0．86、0．79、0．83，P均〈0．05）。结论LKD患者心脏SPECT显示不同程度的心肌示踪剂摄取减低，SPECT总评分与部分心脏超声指标有很好的一致性，但未见与心脏生物标志物有统计学意义的相关。Objective To explore the relationship between cardiac single-photon emission computed tomography （SPECT） imaging scores of latent Keshan disease （LKD） and the parameters of cardiac biomarkers and echocardiography. Methods Ten patients with latent Keshan disease were examined with ^99Tc-MIBI SPECT and echocardiography, left ventricle images were scored with 20-segment model. The superoxide dismutase （SOD）, malondialdehyde （MDA）, and cardiac troponin I （cTnI） were measured with colorimetry and ELISA. Spearman correlation between cardiac SPECT image scores and the parameters was analyzed. Results The cardiac SPECT image of the patients with latent Keshan disease showed varied degrees of reduced intakes,the average of the fourcategory scores was （17 ± 4）, ranged from 11 to 24. The average of the two-category scores was （13 ± 2）, ranged from 9 to 17. Spearman correlation analysis showed that SPECT four-category scores and two-category scores were not statistically correlated with SOD, MDA and cTnI （r = - 0.35, 0.25, 0.27, 0.00, 0.34 and 0.08, all P 〉0.05）. Spearman correlation analysis showed that SPECT four-category scores were statistically correlated with left ventricular end-diastolic volume （LVEDV） and left ventricular mass （LVM） （r = 0.71, 0.77, all P 〈 0.05）; two- category scores were significantly correlated with left ventricular posterior wall thickness （LVPWT）, left ventricular cardiac output （CO）, LVEDV, left ventricular end-systolic volume （LVESV） and LVM （r = 0.81, 0.75, 0.86, 0.79 and 0.83, all P 〈 0.05）. Conclusions The cardiac SPECT images of the patients with LKD have showed reduced uptake by myocardial. SPECT scores are in good consistency with the parameters of echocardiography although they are not correlated significantly in statistics with the parameters of cardiac biomarkers.

关 键 词：潜在型克山病 单光子发射型计算机断层显像 评分 心脏生物标志物 心脏超声 

分 类 号：R542.3[医药卫生—心血管疾病]