潜在型克山病心脏正电子发射断层显像与心肌损伤及抗氧化标志和心脏功能的关系

The relationship between cardiac positron emission tomography of latent Keshan disease and the markers of myocardial injury and antioxidation and markers of heart function

目的探讨潜在型克山病（1atent keshan disease，LKD）患者心脏正电子发射断层显像（positron emission tomography，PET）特征与心肌损伤及抗氧化标志、心脏功能的关系。方法对10例LKD患者进行静息^18F标记的脱氧葡萄糖（^18F-deoxyglucose，^18F-FDG）PET检查，获得17节段模型心肌代谢图像，计算各节段评分。利用酶联免疫吸附法、比色法测定心肌损伤及抗氧化指标，利用超声检查心脏功能指标．并与PET评分进行Spearman相关分析。结果10例LKD患者^18F—FDGPET心肌代谢显像共检测出126个节段为放射性摄取减低，占74．1％（126／170）。PET二分类评分中，最大值为10．0分，最小值为6．0分，平均为（8．0±2．0）分。PET四分类评分中，最大值为20．3分，最小值为6．4分，平均为（12．3±2．1）分。PET评分与心肌损伤及抗氧化指标的相关分析均无统计学意义（P均〉0．05）。PET四分类评分与心脏功能指标左室舒张末容积（LVEDV）、左室收缩末容积（LVESV）、室间隔厚度（LVST）的相关分析均有统计学意义（r=0．767、0．783、0．669，P均〈0．05）。结论^18F—FDGPET结合心肌损伤及抗氧化指标、心脏功能指标能够为LKD患者心肌损伤的判断提供更全面的临床信息。

Objective To explore the relationship between cardiac positron emission tomography （PET） of latent Keshan disease （LKD） and the markers of myocardial injury and antioxidation and markers of heart function. Methods Ten patients diagnosed latent Keshan disease were inspected by JSF-deoxy glucose （JSF-FDG） PET and myocardial images were scored with 17-segment model. The markers of myocardial injury and antioxidation were examined by enzyme linked immunosorbent assay and colorimetry, the markers of heart function were examined by echocardiography. Spearman correlation was conducted between cardiac PET image scores and these biomarkers. Results Totally 126 segments showed reduced radioactivity uptake, accounting for 74.1% （126/170）. The maximum of PET two-category score was 10.0, the minimum was 6.0, and the mean was 8.0 ± 2.0. The maximum of PET four-category score was 20.3, the minimum was 6.4, and the mean was 12.3 ± 2.1. Spearman correlation analysis showed that PET scores were not statistically significantly correlated with the markers of myocardial injury and antioxidation （all P 〉 0.05）. PET four-category scores were statistically significantly correlated with left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVESV） and left ventricular septal thickness （LVST） （r = 0.767, 0.783, 0.669, all P 〈 0.05）. Conclusion lSF-FDG PET combining with the markers of myocardial injury and antioxidation and markers of heart function may provide comprehensive information in evaluating myocardial injury of the LKD patients.