PET/CT联合显像在雌激素与阿尔茨海默病相关性研究中的价值

The Value of PET/CT Imaging in Alzheimer's Disease Patients with Different Levels of Estradiol

通过研究不同雌二醇(estradiol,E_2)水平阿尔茨海默病(AD)患者血清中肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)及载脂蛋白E(ApoE)的表达,探讨11 C-PIB、18F-FDG PET/CT联合显像对AD的诊断价值。分析绝经后女性AD患者75例,依据雌激素水平分为低E_2组(E_2<16.2 pmol/L,n=36)、正常E_2组(16.2pmol/L≤E_2<65.7pmol/L,n=39)。检测两组患者血清中ApoE等位基因(ε2、ε3、ε4)表达率、TNF-α表达水平以及PET/CT脑显像标准化摄取比值(standard uptake radio,SUVR)。研究发现,在不同E_2组AD患者中,低E_2组^(18)F-FDG联合11 C-PIB及单独11 C-PIB脑显像诊断AD的灵敏度均较正常E_2组高,差异显著(χ~2=4.869,P=0.027;χ~2=3.636,P=0.047);AD患者E_2水平与SUVR及TNF-α表达水平均呈负相关关系(r=-0.363,P=0.001;r=-0.248,P=0.032),而SUVR及TNF-α表达水平之间无明显相关性(r=0.161,P=0.168);低E_2水平AD患者组ApoE等位基因表达率高,差异显著(Z=-2.228,P=0.026)。结果表明,^(11)C-PIB和^(18)F-FDG联合显像对AD患者具有较高的诊断价值。

The expressions of aplipoprotein E（ApoE）,tumor necrosis factor-α（TNF-α）in Alzheimer＇s disease（AD）patients with different levels of estrogen were investigated to evaluate the diagnosis of combined PET/CT imaging（11 C-PIB and 18 F-FDG）on AD.A total of 75 female AD patients were divided into low level of estradiol group（E2〈16.2 pmol/L,n=36）and normal level of estradiol group（16.2 pmol/L≤E265.7 pmol/L,n=39）according to their estradiol levels.All the patients underwent PET/CT imaging（11 C-PIB and 18 F-FDG）.The sensitivity of PET/CT imaging,the standard uptake value radio,the expression rates of subtype ApoE（ε2,ε3,ε4）,and the expression levels of TNF-αwere detected.The relationship between E2 and the expression rates of ApoE,the levels of TNF-αand SUVR were analyzed by Pearson analysis.In the low level of E2 group,the sensitivity of PET/CT for 11 C-PIB alone,11 C-PIB combined with 18 F-FDG was higher than in normal E2 group（χ^2=4.869,P=0.027;χ^2=3.636,P=0.047）;while the sensitivity of 18 F-FDG PET/CT imagings on brain between the two groups had no significant difference（χ^2=2.007,P =0.157）.The expression level of E2 with SUVR and the expression level of TNF-αin two groups of AD patients had the negative correlations（r=-0.363,P=0.001;r=-0.248,P=0.032）.The expression rate of ApoEε4 allelic genes of AD patients was higher than that ofε2 andε3 allelic genes,and there was higher expression rates of ApoE in AD patients with the low E2 group（Z=-2.228,P=0.026）.11 C-PIB and 18 F-FDG PET/CT had high value of diagnosis in AD patients.