摘要目的:探讨空腹血糖水平对冠心病患者正电子发射断层扫描显像/X射线计算机体层扫描(PET/CT)心肌代谢显像质量的影响。方法:回顾分析2019至2020年在北京安贞医院完成 18F-脱氧葡萄糖( 18F-FDG)PET/CT心肌代谢显像检查的78例冠心病患者的资料，64例符合入选标准。所有患者禁食8 h以上，口服葡萄糖后静脉注射胰岛素和显像剂 18F-FDG，完成心肌代谢图像采集。心肌代谢图像质量不影响临床诊断为合格，图像质量评分(IQ)0～2分；否则为不合格，评分为3～4分。分析比较合格组(55例)与不合格组(19例)患者性别、年龄、糖尿病患病率、体质指数、空腹血糖、糖化血红蛋白、糖化血清白蛋白、三酰甘油、游离脂肪酸以及服用调脂药、口服降糖药等差异及其影响因素。 结果:心肌代谢显像不合格组的糖尿病患病率高于合格组(63.2%和33.3%， χ2＝4.872， P＝0.027)。不合格组患者空腹血糖、糖化血红蛋白及糖化血清白蛋白水平较合格组升高[7.67(6.02，11.64)和5.52(4.97，6.37)mmol/L；7.30(6.43，8.70)和6.20(5.60，6.87)%；19.8(15.1，24.1)和14.8(13.9，16.8)%，U＝-3.909、-2.419和-3.042， P<0.001， P＝0.016和0.002]。多因素Logistic回归分析显示空腹血糖是 18F-FDG PET/CT心肌代谢显像质量不合格的独立危险因素， OR值1.62(95% CI：1.19～2.20， P＝0.002)。空腹血糖≥6.66 mmol/L则是心肌显像不合格的ROC曲线下面积为0.81(95% CI：0.69～0.93， P<0.001)。 结论:空腹血糖水平是影响 18F-FDG PET/CT心肌代谢显像质量的独立危险因素，糖尿病患者应积极控制血糖。

abstractsObjective:To investigate the effects of fasting blood glucose levels on the quality of myocardial metabolism imaging via positron emission tomography/X-ray computed tomography(PET/CT)in patients with coronary heart disease.Methods:A total of 78 patients with coronary heart disease from 2019 to 2020 undergone 18-fluorine deoxyglucose( 18F-FDG)PET/CT myocardial imaging in Beijing Anzhen Hospital were retrospectively analyzed, with 64 patients meeting the inclusion criteria eventually enrolled in this study.All patients fasted over 8 hours and were injected with insulin and 18F-FDG following an oral glucose load.Then myocardial imaging evaluations were performed.Depending on whether the myocardial image quality(IQ)offered a match with clinical diagnosis, a score between 0-2 from the semiquantitative scoring system was defined as good IQ, while a score between 3-4 defined as poor IQ.Differences in sex, age, rate of diabetes, body mass index, fasting blood glucose(FBG), glycosylated hemoglobin, glycosylated serum albumin, triglycerides and free fatty acids, lipid-regulating drugs, and oral antidiabetic medications were analyzed between the good( n=55)and poor( n=19)image groups, and risk factors were examined. Results:The diabetes mellitus rate was higher in the poor group than in the good group(63.2% vs.33.3%, χ2=4.872, P=0.027). FBG, glycosylated hemoglobin and glycosylated serum albumin levels in the poor group were increased compared with the good group[7.67(6.02, 11.64)mmol/L vs.5.52(4.97, 6.37)mmol/L, 7.30(6.43, 8.70)% vs.6.20(5.60, 6.87)%, 19.8(15.1, 24.1)% vs.14.8(13.9, 16.8)%, U=-3.909, -2.419 and -3.042, P<0.001, P=0.016 and 0.002, respectively]. Multivariate Logistic regression analysis showed that FBG was an independent risk factor for poor imaging( OR=1.62, 95% CI: 1.19-2.20, P=0.002). The area under the receiver operator characteristic(ROC)curve for FBG was 0.811(95% CI: 0.69-0.93, P<0.001), and the cut-off value for FBG was 6.66 mmol/L. Conclusions:FBG is an independent risk factor for myocardial image quality.Patients with diabetes mellitus should rigorously control their blood glucose levels.