同位素 ›› 2017, Vol. 30 ›› Issue (4): 276-282.DOI: 10.7538/tws.2017.youxian.035

• 放射性同位素应用技术 • 上一篇    下一篇

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

陆国秀1;张国旭1;郝珊瑚1;郭佳1;张文文1;王治国1;张景华2   

  1. 1.沈阳军区总医院 核医学科,辽宁 沈阳110016;2.沈阳军区总医院 神经内科,辽宁 沈阳110016
  • 出版日期:2017-11-20 发布日期:2017-11-10

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

LU Guo-xiu1;ZHANG Guo-xu1;HAO Shan-hu1;GUO Jia1;ZHANG Wen-wen1;WANG Zhi-guo1;ZHANG Jing-hua2   

  1. 1.Department of Nuclear Medicine, General Hospital of Shenyang Military Command, Shenyang 110016, China; 2.Department of Neurology, General Hospital of Shenyang Military Command, Shenyang 110016, China
  • Online:2017-11-20 Published:2017-11-10

摘要:

通过研究不同雌二醇(estradiol, E2)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11C-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E2组(E2<16.2 pmol/L, n=36)、正常E2组(16.2 pmol/L≤E2<65.7 pmol/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E2组AD患者中,低E218F-FDG联合11C-PIB及单独11C-PIB脑显像诊断AD的灵敏度均较正常E2组高,差异显著(χ2=4.869,P=0.027;χ2=3.636, P=0.047);AD患者E2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E2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,11C-PIB和18F-FDG联合显像对AD患者具有较高的诊断价值。

关键词: 阿尔茨海默病, 雌二醇, 载脂蛋白E, 肿瘤坏死因子-&alpha

Abstract:

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 (11C-PIB and 18F-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≤E2<65.7 pmol/L, n=39) according to their estradiol levels. All the patients underwent PET/CT imaging (11C-PIB and 18F-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-α were detected. The relationship between E2 and the expression rates of ApoE, the levels of TNF-α and SUVR were analyzed by Pearson analysis. In the low level of E2 group, the sensitivity of PET/CT for 11C-PIB alone, 11C-PIB combined with 18F-FDG was higher than in normal E2 group (χ2=4.869,P=0.027; χ2=3.636, P=0.047); while the sensitivity of 18F-FDG PET/CT imagings on brain between the two groups had no significant difference (χ2=2.007, P=0.157). The expression level of E2 with SUVR and the expression level of TNF-α in 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 ApoE ε4 allelic genes of AD patients was higher than that of ε2 and ε3 allelic genes, and there was higher expression rates of ApoE in AD patients with the low E2 group (Z=-2.228,P=0.026). 11C-PIB and 18F-FDG PET/CT had high value of diagnosis in AD patients.

Key words: Alzheimer’s disease, estradiol, apolipoprotein E, tumor necrosis factor-α