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目的 探讨慢型克山病患者心脏单光子发射型计算机断层显像(single-photon emission computed tomography,SPECT)特征与心力衰竭标志物之间的关系.方法 对21例慢型克山病患者进行99m锝-甲氧基异丁基异腈(99mTc-MIBI) SPECT检查,获得20节段模型心肌灌注图像,计算各节段评分;采用酶联免疫吸附法、比色法测定患者血液中N末端B型利钠肽原(NT-ProBNP)、脑钠肽(BNP)、心肌肌钙蛋白I(cTnI)、骨桥蛋白(OPN)、基质金属蛋白酶(MMP)1、基质金属蛋白酶抑制剂(TIMP)1、可溶性生长刺激表达因子2蛋白(sST2)、丙二醛(MDA)、超氧化物歧化酶(SOD),并与SPECT评分进行Spearman相关分析.结果 克山病患者心尖、近心尖部、心中部、基底部四级评分分别为(0.93±0.03)、(0.73±0.34)、(0.97±0.24)、(1.67±0.23)分,20节段平均为(1.10±0.46)分;二分类评分分别为(0.83±0.03)、(0.65±0.25)、(0.83±0.16)、(1.00±0.00)分,20节段平均为(0.83±0.21)分;SPECT总评分与cTnI、OPN的相关系数分别为-0.467、-0.502(P均＜0.05).结论 慢型克山病患者心脏SPECT显像可以发现患者心脏摄取减低及分布,SPECT评分对患者慢性心力衰竭和预后有一定参考价值.“,”Objectives To explore the relationship between cardiac single-photon emission computed tomography (SPECT) imaging score of patients with chronic Keshan disease and the markers of heart failure.Methods Twenty-one Keshan disease patients were examined with 99mTc-MIBI SPECT and myocardial images were scored with 20-segment model.The N-terminal pro-B-type natriuretic peptide (NT-ProBNP),brain natriuretic peptide (BNP),cardiac troponin I (cTnI),osteopontin (OPN),matrix metalloproteinase 1 (MMP1),tissue inhibitor of metalloproteinases (TIMP1),soluble growth stimulating express gene 2 (sST2),malondialdehyde (MDA),superoxide dismutase (SOD) were measured with ELISA and colorimetry.Spearman correlation was conducted between cardiac SPECT image scores and the biomarkers.Results The four-category scores of apex,distal,mid and base were 0.93 ± 0.03,0.73 ± 0.34,0.97 ± 0.24 and 1.67 ± 0.23,and the average score of 20 segments was 1.10 ± 0.46;the two-category scores of apex,distal,mid and base were 0.83 ± 0.03,0.65 ± 0.25,0.83 ± 0.16 and 1.00 ± 0.00,and the average score of 20 segments was 0.83 ± 0.21.Spearman correlation analysis showed that SPECT binary scores were statistically correlated with cTnl (r =-0.467,P ＜ 0.05) and OPN (r =-0.502,P ＜ 0.05).Conclusion The cardiac SPECT image of the patients with chronic Keshan disease may have reference value in evaluating heart failure and cardiac remodeling of the patients.