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目的 探讨慢型克山病患者心脏正电子发射断层显像/X线计算机体层成像仪(PET/CT)检查评分与慢性心力衰竭标志等生化指标间的关系.方法 在克山病病区确诊的以往病例中,选取15例慢型克山病患者进行心脏PET/CT检查和心脏超声,PET/CT检查左心室17个节段并进行评分.评分标准:轻度0～17分、中度18～ 34分、重度35～ 51分.采集全部患者静脉血,进行血清慢性心力衰竭标志等生化指标的测定,包括N末端B型利钠肽原(NT-ProBNP)、脑钠肽(BNP)、心肌肌钙蛋白Ⅰ(cTnⅠ)、基质金属蛋白酶1(MMP1)、基质金属蛋白酶抑制剂(TIMP1)、超氧化物歧化酶(SOD)、丙二醛(MDA)、血管紧张素Ⅱ(AngⅡ)和骨桥蛋白(OPN).AngⅡ测定采用放射免疫法(RIA),SOD、MDA测定采用比色法,其他测定采用酶联免疫吸附试验(ELISA).将PET/CT检查评分总分与慢性心力衰竭标志等生化指标进行Spearman相关分析.结果 15例患者心脏PET/CT检查均显示有不同程度的摄取降低,各节段评分总分最小者为9分,最大者为38分,平均为(23±9)分.相关分析显示,患者心脏PET/CT检查评分与cTnⅠ和NT-ProBNP的相关性有统计学意义(r=0.714、0.684,P均＜ 0.01),与BNP、MMP1、TIMP1、MDA、SOD、AngⅡ、OPN的相关性无统计学意义(r=1.000、0.948、0.749、0.620、0.428、0.685、0.094,P均＞0.05).患者心脏PET/CT检查评分与心脏超声检查的一致性较高.结论 慢型克山病患者心脏PET/CT检查左心室各节段评分对判断患者慢性心力衰竭有一定的参考价值.“,”Objective To explore the relationship between chronic Keshan disease cardiac PET/CT score and the markers of heart failure and cardiac remodeling.Methods Totally 15 old cases of Keshan disease patients from previous studies were examined with cardiac echocardiography and PET/CT.The score of the intake decrease of the 17 segments of the left ventricle was divided into three categories (mild:0-17; moderate:18-34; severe:35-51); the levels of serum N-terminal B-type natriuretic peptide prosema(NT-ProBNP),B-type natriuretic peptide (BNP),cardiac troponin Ⅰ (cTnⅠ),matrix metalloproteinase 1 (MMP1),matrix metallo-proteinase inhibitor (TIMP1),superoxide dismutase (SOD),malondialdehyde(MDA),angiotensin Ⅱ (Ang Ⅱ) and osteopontin (OPN) were measured,and correlation analysis between cardiac PET/CT scores of the patients and the biomarkers was conducted.Results All the 15 patients showed different degrees of reduced intakes,the mean of the total PET/CT score was 23 ± 9,the minimum was 9,and the maximum was 38.Spearman correlation analysis showed that cardiac PET/CT scores were statistically significantly correlated with cTnⅠ and NT-ProBNP (r =0.714,0.684,all P ＜ 0.01),and were not statistically correlated with BNP,MMP1,TIMP1,MDA,SOD,AngⅡ and OPN (r =1.000,0.948,0.749,0.620,0.428,0.685,0.094,all P ＞ 0.05).The cardiac PET/CT scores of the patients were in good consistency with the results of cardiac ultrasound examination.Conclusion The cardiac PET/CT score of the patients with chronic Keshan disease may have important reference value in evaluating heart failure and cardiac remodeling of the patients.