摘要目的 探讨潜在型克山病(LKD)患者心脏单光子发射型计算机断层显像(SPECT)特征与心脏生物标志物及超声指标的关系.方法 对10例LKD患者进行99m锝-甲氧基异丁基乙腈(99mTc-MIBI)SPECT和心脏超声检查,SPECT检查获得20节段模型心肌灌注图像,计算各节段四等级、二分类总评分.采用比色法、酶联免疫吸附法测定患者血液中超氧化物歧化酶(SOD)、丙二醛(MDA)、心肌肌钙蛋白Ⅰ(cTnⅠ).SPECT总评分和各指标的相关性采用Spearman分析.结果 所有患者心脏SPECT检查均显示有不同程度的示踪剂摄取降低.相关分析显示,SPECT四等级总评分范围为11～ 24分,平均(17±4)分;二分类总评分范围为9～ 17分,平均(13±2)分.SPECT四等级、二分类总评分与SOD、MDA、cTnⅠ无相关性(r=-0.35、0.25、0.27、0.00、0.34、0.08,P均＞ 0.05).SPECT四等级总评分与左室舒张末容积(LVEDV)、心脏质量(LVM)相关性比较有统计学意义(r=0.71、0.77,P均＜0.05),二分类总评分与舒张末左室后壁厚度(LVPWT)、心排出量(CO)、LVEDV、左室收缩末容积(LVESV)、LVM相关性比较有统计学意义(r=0.81、0.75、0.86、0.79、0.83,P均＜0.05).结论 LKD患者心脏SPECT显示不同程度的心肌示踪剂摄取减低,SPECT总评分与部分心脏超声指标有很好的一致性,但未见与心脏生物标志物有统计学意义的相关.

abstractsObjective To explore the relationship between cardiac single-photon emission computed tomography (SPECT) imaging scores of latent Keshan disease (LKD) and the parameters of cardiac biomarkers and echocardiography.Methods Ten patients with latent Keshan disease were examined with 99mTc-MIBI SPECT and echocardiography,left ventricle images were scored with 20-segment model.The superoxide dismutase (SOD),malondialdehyde (MDA),and cardiac troponin Ⅰ (cTnⅠ) were measured with colorimetry and ELISA.Spearman correlation between cardiac SPECT image scores and the parameters was analyzed.Results The cardiac SPECT image of the patients with latent Keshan disease showed varied degrees of reduced intakes,the average of the fourcategory scores was (17 ± 4),ranged from 11 to 24.The average of the two-category scores was (13 ± 2),ranged from 9 to 17.Spearman correlation analysis showed that SPECT four-category scores and two-category scores were not statistically correlated with SOD,MDA and cTnⅠ (r =-0.35,0.25,0.27,0.00,0.34 and 0.08,all P ＞ 0.05).Spearman correlation analysis showed that SPECT four-category scores were statistically correlated with left ventricular end-diastolic volume (LVEDV) and left ventricular mass (LVM) (r =0.71,0.77,all P ＜ 0.05);twocategory scores were significantly correlated with left ventricular posterior wall thickness (LVPWT),left ventricular cardiac output (CO),LVEDV,left ventricular end-systolic volume (LVESV) and LVM (r =0.81,0.75,0.86,0.79 and 0.83,all P ＜ 0.05).Conclusions The cardiac SPECT images of the patients with LKD have showed reduced uptake by myocardial.SPECT scores are in good consistency with the parameters of echocardiography although they are not correlated significantly in statistics with the parameters of cardiac biomarkers.