不同体质量指数阿尔茨海默病患者PET/CT联合显像和IL-6水平及ApoE表达率检测及其临床意义

摘要

Objective:To detect the interleukin-6 (IL-6) levels and expressions of applipoprotein E (ApoE) in the Alzheimer's disease (AD) patients with different body-mass indexes (BMI),and to explore the diagnotic value of 11Pittsburgh comound-B (11C-PIB) combined with 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging in AD.Methods:A total of 58 AD patients were divided into four groups according to their BMI:low BMI group(BMI <18.5 kg·m-2,n=18),normal BMI group(18.5 kg·m-2≤BMI <24.9 kg·m-2,n=13),high BMI group(24.9 kg·m-2≤BMI <29.9 kg·m-2,n=12)and obese group(BMI ≥29.9 kg·m-2,n=15).All the patients underwent PET/CT imaging (11C-PIB and 18F-FDG).The sensitivity,specificity and accuracy rate,the expression rates of ApoE (ε2,ε3,and ε4) and the levels of serum IL-6 were detected.The relationship between BMI and the expression rates of ApoE and the serum levels of IL-6 were analyzed by Spearman analysis.Results:The sensitivity,specificity,and accuracy rate of the patients in low BMI group diagnosed by 11C-PIB and 18F-FDG PET/CT were 87.5%,80.0%,and 84.6%,which were higher than those diagnosed by 11C-PIB (55.6%,50.0%,and 53.8%) or 18F-FDG (42.9%,50.0%,and 46.2%)alone (P<0.05).The serum levels of IL-6 and BMI of the AD patients had a negative correlation(r=-0.407,P=0.002).The expression rate of ApoE ε4 allelic gene(60.3%) of the AD patients was higher than those of ε2(18.9%) and ε3 allelic genes(20.7%),but there was no correlation between the BMI and the expression rates of different ApoE allelic genes of the AD patients(r=-0.028,P=0.833).Conclusion:11C-PIB and 18F-FDG PET/CT has a high diagnotic value in the AD patients.11C-PIB and 18F-FDG combinated with serum IL-6 level and BMI could diagnose and evaluate AD more exactly.%目的:检测不同体质量指数(BMI)阿尔茨海默病(AD)患者血清中白细胞介素6(IL-6)水平及载质蛋白E(ApoE)的表达,探讨11碳-匹斯堡复合物(11C-PIB)和18氟-脱氧葡萄糖(18F-FDG)PET/CT联合显像对AD的诊断价值.方法:58例AD患者依据BMI分为低体质量组(BMI <18.5 kg·m-2,n=18)、正常体质量组(18.5 kg·m-2≤BMI <24.9 kg·m-2,n=13)、超重组(24.9 kg·m-2≤BMI <29.9 kg·m-2,n=12)和肥胖组(BMI ≥29.9 kg·m-2,n=15).比较11C-PIB 和18F-FDG PET/CT脑显像诊断AD的灵敏度、特异度和准确率.检测各组患者ApoE等位基因(ε2、ε3及ε4)表达率和血清IL-6水平.BMI与ApoE等位基因表达率及血清IL-6水平的相关性分析采用Spearman相关分析.结果:18F-FDG联合11C-PIB PET/CT显像对低体质量组AD患者的诊断灵敏度、特异度和准确率分别为87.5%、80.0%和84.6%,高于单独11C-PIB(55.6%、50.0%和53.8%)或18F-FDG显像(42.9%、50.0%和46.2%)(P<0.05);AD患者BMI与血清IL-6水平呈负相关关系(r=-0.407,P=0.002);ApoE等位基因各亚型中,ε4表达率(60.3%)高于ε2(18.9%)和ε3(20.7%),但AD患者BMI与ApoE等位基因不同亚型表达率之间无相关性(r=-0.028,P=0.833).结论:11C-PIB和18F-FDG PET/CT联合显像对AD患者具有较高的诊断价值;11C-PIB 、18F-FDG 结合血清IL-6水平及BMI可以更好地诊断和评估AD.