不同体质量指数阿尔茨海默病患者PET/CT联合显像和IL-6水平及ApoE表达率检测及其临床意义  

PET/CT imaging and detection of levels of IL-6 and expression rates of ApoE in Alzheimer's disease patients with different body-mass indexes and their clinical significances

作　　者：陆国秀[1] 张国旭[1] 郝珊瑚[1] 郭佳[1] 张文文[1] 张景华[2] 王治国[1] LU Guoxiu ZHANG Guoxu HAO Shanhu GUO Jia ZHANG Wenwen ZHANG Jinghua WANG Zhiguo(Department of Nuclear Medicine, General Hospital, Shenyang Military Command, Shenyang 110016, China Department of Neurology, General Hospital, Shenyang Military Command, Shenyang 110016, China)

机构地区：[1]沈阳军区总医院核医学科,辽宁沈阳110016 [2]沈阳军区总医院神经内科,辽宁沈阳110016

出　　处：《吉林大学学报（医学版）》2017年第3期611-616,共6页Journal of Jilin University：Medicine Edition

基　　金：辽宁省自然科学基金资助课题((2014020066)

摘　　要：目的:检测不同体质量指数(BMI)阿尔茨海默病(AD)患者血清中白细胞介素6(IL-6)水平及载质蛋白E(ApoE)的表达,探讨^(11)碳-匹斯堡复合物(^(11)C-PIB)和^(18)氟-脱氧葡萄糖(^(18) F-FDG)PET/CT联合显像对AD的诊断价值。方法:58例AD患者依据BMI分为低体质量组(BMI<18.5kg·m^(-2),n=18)、正常体质量组(18.5kg·m^(-2)≤BMI<24.9kg·m^(-2),n=13)、超重组(24.9kg·m^(-2)≤BMI<29.9kg·m^(-2),n=12)和肥胖组(BMI≥29.9kg·m^(-2),n=15)。比较^(11)C-PIB和^(18)F-FDG PET/CT脑显像诊断AD的灵敏度、特异度和准确率。检测各组患者ApoE等位基因(ε2、ε3及ε4)表达率和血清IL-6水平。BMI与ApoE等位基因表达率及血清IL-6水平的相关性分析采用Spearman相关分析。结果:^(18)F-FDG联合^(11)C-PIB PET/CT显像对低体质量组AD患者的诊断灵敏度、特异度和准确率分别为87.5%、80.0%和84.6%,高于单独^(11)C-PIB(55.6%、50.0%和53.8%)或^(18)F-FDG显像(42.9%、50.0%和46.2%)(P<0.05);AD患者BMI与血清IL-6水平呈负相关关系(r=-0.407,P=0.002);ApoE等位基因各亚型中,ε4表达率(60.3%)高于ε2(18.9%)和ε3(20.7%),但AD患者BMI与ApoE等位基因不同亚型表达率之间无相关性(r=-0.028,P=0.833)。结论:^(11)C-PIB和^(18)F-FDG PET/CT联合显像对AD患者具有较高的诊断价值;^(11)C-PIB、^(18)F-FDG结合血清IL-6水平及BMI可以更好地诊断和评估AD。Objective：To detect the interleukin-6 （IL-6） levels and expressions of applipoprotein E （ApoE） in the Alzheimer＆#39;s disease （AD） patients with different body-mass indexes （BMI）,and to explore the diagnotic value of 11Pittsburgh comound-B （11C-PIB） combined with 18F-fluorodeoxyglucose （18F-FDG） PET/CT imaging in AD.Methods：A total of 58 AD patients were divided into four groups according to their BMI：low BMI group（BMI 〈18.5 kg·m^-2,n=18）,normal BMI group（18.5 kg·m-2≤BMI 〈24.9 k·m^-2,n=13）,high BMI group（24.9 kg·m-2≤BMI 〈29.9 kg·m^-2,n=12）and obese group（BMI ≥29.9 kg·m^-2,n=15）.All the patients underwent PET/CT imaging （11C-PIB and 18F-FDG）.The sensitivity,specificity and accuracy rate,the expression rates of ApoE （ε2,ε3,and ε4） and the levels of serum IL-6 were detected.The relationship between BMI and the expression rates of ApoE and the serum levels of IL-6 were analyzed by Spearman analysis.Results：The sensitivity,specificity,and accuracy rate of the patients in low BMI group diagnosed by 11C-PIB and 18F-FDG PET/CT were 87.5%,80.0%,and 84.6%,which were higher than those diagnosed by 11C-PIB （55.6%,50.0%,and 53.8%） or 18F-FDG （42.9%,50.0%,and 46.2%）alone （P〈0.05）.The serum levels of IL-6 and BMI of the AD patients had a negative correlation（r=-0.407,P=0.002）.The expression rate of ApoE ε4 allelic gene（60.3%） of the AD patients was higher than those of ε2（18.9%） and ε3 allelic genes（20.7%）,but there was no correlation between the BMI and the expression rates of different ApoE allelic genes of the AD patients（r=-0.028,P=0.833）.Conclusion：11C-PIB and 18F-FDG PET/CT has a high diagnotic value in the AD patients.11C-PIB and 18F-FDG combinated with serum IL-6 level and BMI could diagnose and evaluate AD more exactly.

关 键 词：阿尔茨海默病 体质量指数 载质蛋白E 白细胞介素6 11碳-匹斯堡复合物 18氟-脱氧葡萄糖正 电子发射体层摄影技术 计算机断层扫描 

分 类 号：R741.04[医药卫生—神经病学与精神病学]