应用18F-FDG PET/CT活体成像探讨吡格列酮对兔动脉粥样硬化斑块易损性与钙化的影响  

Effect of pioglitazone on vulnerability and calcification of atherosclerotic plaque in rabbits by 18F-FDG PET/CT

作　　者：田鹏 张韫欢 苏琳 王国强 赵全明[3] 许金鹏[2] TIAN Peng;ZHANG Yun-huan;SU Lin;WANG Guo-qiang;ZHAO Quan-ming;XU Jin-peng(Medical College of Hebei University,Baoding,Hebei 071000,China;Department of Cardiovascular Medicine,Affiliated Hospital of Hebei University,Baoding,Hebei 071000,China;Department of Cardiovascular Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]河北大学医学院,河北保定071000 [2]河北大学附属医院心内科,河北保定071000 [3]首都医科大学附属北京安贞医院心内科,北京100029

出　　处：《岭南心血管病杂志》2019年第4期464-468,共5页South China Journal of Cardiovascular Diseases

基　　金：国家自然科学基金项目(项目编号:81355392);河北省重点研发计划项目(项目编号:18277755D);河北省财政厅、河北省卫生计生委2017年政府资助临床医学优秀人才培养和基础课题研究项目(项目编号:冀财社[2017]46号)

摘　　要：目的应用18氟-氟代脱氧葡萄糖(18F-fluorodeoxyglucose,18F-FDG)正电子发射型计算机断层显像(positron emission computed tomography,PET)/计算机断层扫描(computed tomography,CT)探讨吡格列酮对实验性兔动脉粥样硬化斑块易损性及钙化的作用,及钙化与易损性之间的相关关系。方法 20只雄性新西兰大白兔随机分为吡格列酮组(n=10)和对照组(n=10)。制作动脉粥样硬化模型,吡格列酮组给予每日吡格列酮灌胃。两组大白兔在第8周和第18周抽血检测血清总胆固醇(total cholesterol,TC),三酰甘油(triglyceride,TG),低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C),高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP),基质金属蛋白酶9(matrix metalloproteinase-9,MMP-9)的浓度,并各进行一次PET/CT扫描,测量标准摄取值(standardized uptake value,SUV)(SUVmax、SUVmean)。实验动物处死,主动脉组织行病理免疫组化,比较两组斑块面积、斑块纤维帽厚度、纤维帽厚度与斑块面积比值、钙化面积百分比。结果两组间第8周与第18周TC、TG、LDL-C浓度比较,差异无统计学意义(P>0.05)。第18周,吡格列酮组hs-CRP[(4.67±0.46)ng/mL vs.(6.21±0.93)ng/mL,P<0.01)]、MMP-9[(43.50±1.94)ng/mL vs.(60.24±3.62)ng/mL,P<0.01]、SUV值(P<0.01)较对照组下降。吡格列酮组第18周时的TG[(1.48±0.85)mmol/L vs.(1.70±0.90)mmol/L,P<0.01]、hs-CRP[(4.67±0.46)ng/mL vs.(6.08±0.75)ng/mL,P<0.01]、MMP-9[(43.50±1.94)ng/mL vs.(50.44±2.05)ng/mL,P<0.01)]、SUV值(P<0.01)均低于第8周时,差异有统计学意义。吡格列酮组相应动脉的斑块面积、钙化面积百分比较对照组低,斑块纤维帽厚度,纤维帽厚度/斑块面积比值较对照组高,差异有统计学意义(P<0.05)。结论18F-FDG PET/CT可以用于评估动脉粥样硬化斑块的易损性,并可以对于血管早期钙化做出提示;吡格列酮可以用于改善动脉粥样硬化斑块的易损性,并可以控制血管早期钙化的发展进程。Objectives To investigate the effect of pioglitazone on atherosclerotic calcification and plaque vulnerability in rabbits by 18F-fluorodeoxyglucose(18F-FDG)/positron emission tomography(PET)/computed tomography(CT)and the correlation between calcification and vulnerability.Methods Twenty male New Zealand white rabbits were randomly divided into pioglitazon group(n=10)and control group(n=10).The model of atherosclerosis was made.Pioglitazone group was given pioglitazone per day.Blood of the rabbits was drawn to exam concentration of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-sensitivity C-reactive protein(hs-RP)and matrix metalloproteinase-9(MMP-9)at the 8th week and 18th week.PET/CT was used to measure mean standardized uptake value(SUVmean)and maximum standardized uptake value(SUVmax)at the 8th week and 18th week respectively.Finally all the rabbits were euthanized,and of which aortic histopathological assessment was performed.Area of plaque,fiber cap thickness,the ratio of fiber cap thickness to plaque area and the percentage of calcified area were compared between the two groups.Results There was no statistical difference in concentrations of TC,TG and LDL-C between the two groups at 8th week and 18th week.At 18th week,concentrations of hs-CRP[(4.67±0.46)ng/mL vs.(6.21±0.93)ng/mL,P<0.01)],MMP-9[(43.50±1.94)ng/mL vs.(60.24±3.62)ng/mL,P<0.01]and SUV(P<0.01)in pioglitazone group were lower than those of control group.Concentration of TG[(1.48±0.85)mmol/L vs.(1.70±0.90)mmol/L,P<0.01],hs-CRP[(4.67±0.46)ng/mL vs.(6.08±0.75)ng/mL,P<0.01]、MMP-9[(43.50±1.94)ng/mL vs.(50.44±2.05)ng/mL,P<0.01)]and SUV(P<0.01)in pioglitazone group were lower at the 18th week than those at the 8th week.In pioglitazone group,the plaque area,the percentage of calcified area were lower than those of control group,while the thickness of plaque fiber cap,the ratio of fiber cap thickness to plaque area were higher than those of control group(P<0.05).Conclusions 18F-FDG PET/CT can be used to

关 键 词：动脉粥样硬化 斑块易损性 吡格列酮 炎症 正电子发射型计算机断层显像/计算机断层扫描 

分 类 号：R541.4[医药卫生—心血管疾病]