静脉糖负荷联合胰岛素法调控血糖在猪^(18)F-FDG PET/CT心肌显像中的应用

Application of intravenous glucose loading combined with insulin regulating blood glucose in porcine ^(18)F-FDG PET/CT myocardial imaging

目的观察静脉糖负荷联合胰岛素法在猪^(18)F-FDG PET/CT心肌显像中调控血糖的应用价值。方法以30头实验用小型猪建立急性心肌梗死模型,并于建模后第1、4周行^(18)F-FDG PET/CT心肌显像,图像质量分为优、良和差。采用静脉糖负荷联合胰岛素法调节血糖浓度,测量并计算基础血糖值、血糖升高百分比、二次血糖值、血糖下降百分比、末次血糖值、存活心肌百分比及左心室射血分数(LVEF),采用多因素Logistic回归分析获得影响图像质量的因素。结果最终26头实验猪入组,完成PET/CT显像52头次,其中质量优组24头次,良组19头次,差组9头次。3组间基础血糖值、血糖升高百分比、二次血糖值、血糖下降百分比及末次血糖值差异均有统计学意义(P均<0.05),存活心肌百分比及LVEF差异均无统计学意义(P均>0.05)。二元多因素Logistic回归分析显示基础血糖值、血糖升高百分比、血糖下降百分比和末次血糖值是影响图像质量的因素(P均<0.05)。结论以静脉糖负荷联合胰岛素法在实验猪^(18)F-FDG PET/CT心肌显像中调控血糖,是有效、可行的方法。

Objective To explore the value of intravenous injection of glucose load combined with insulin in regulating blood glucose in pigs undergoing 18 F-FDG PET/CT myocardial imaging.Methods Totally 30 small experimental pigs were selected.On the first and 4th week after the establishment of acute myocardial infarction models,SPECT myocardial perfusion imaging and PET metabolic imaging were performed with intravenous injection of glucose load combined with insulin to control the blood glucose.The images were classified as excellent,good or poor group according to the quality scores.The base blood glucose,the percentage of blood glucose increase,the second time blood glucose,the percentage of blood glucose decrease,the last time blood glucose,the percentage of survival myocardium and the left ventricular ejected fraction(LVEF)were measured.Then the Logistic regression analysis was used to explore the influence factors on image quality.Results Totally 26 pigs were enrolled,and 52 times of metabolic imaging were obtained.The image quality of 24 times was excellent,of 19 times was good and of 9 times was poor.The base blood glucose,the percentage of blood glucose increase,the second time blood glucose,the percentage of blood glucose decrease and the last time blood glucose were all statistically different among the three groups(all P<0.05),while the percentage of survival myocardium and the LVEF had no statistical difference(both P>0.05).Multivariate Logistic regression analysis showed that 4 factors,including the base blood glucose,the percentage of blood glucose increase,the percentage of blood glucose decrease and the last time blood glucose were the influence factors on image quality(all P<0.05).Conclusion Intravenous injection of glucose load combined with insulin is a feasible and effective method in regulating blood glucose for pigs undergoing 18 F-FDG PET/CT.