摘要:目的 应用18F-FDG PET/CT、病理和免疫组化分析,探讨PET/CT在兔动脉粥样硬化早期钙化检测中的作用,以及吡格列酮治疗早期钙化的作用.材料与方法 16只新西兰雄性大白兔采用抽签法随机分为吡格列酮组和对照组,每组8只.制做动脉粥样硬化模型.吡格列酮组兔用吡格列酮灌胃,高脂饲养20周,抽血检测高敏C反应蛋白及基质金属蛋白酶-9.用PET/CT测量平均标准化摄取值(SUVmean)和最大标准化摄取值(SUVmax),兔主动脉行免疫组化,测量并比较两组斑块面积、巨噬细胞密度、钙化面积百分比及凋亡指数.结果 第20周,吡格列酮组高敏C反应蛋白(4.27±0.43比6.51±0.91,P<0.01)、基质金属蛋白酶-9(41.52±1.99比62.21±3.60,P<0.05)、SUVmean(0.55±0.18比0.68±0.21,P<0.01)及SUVmax (0.70±0.19比0.82±0.30,P<0.05)均显著低于对照组.对照组斑块面积、巨噬细胞密度、钙化面积百分比、凋亡指数均显著高于吡格列酮组.相应动脉段斑块面积与SUVmean(r=0.28,P<0.01)、SUVmax (r=025,P<0.05)呈正相关.巨噬细胞密度与SUVmean (r=0.50,P<0.01)、SUVmax (r=0.46,P<0.01)呈正相关.钙化面积百分比与SUVmean(r=0.50,P<0.01)、SUVmax (r=0.47,P<0.01)呈正相关.凋亡指数与SUVmean (r=0.61,P<0.01)、SUVmax(r=0.60,P<0.01)呈正相关.结论 炎症及巨噬细胞凋亡对动脉粥样硬化早期钙化有重要作用;18F-FDG PET/CT显像能够用于评价微小钙化;吡格列酮能降低动脉粥样硬化实验动物的炎症水平,抑制早期钙化.%Purpose 18F-FDG PET/CT,pathological and immunohistochemical analysis are adopted to explore the value of PET/CT in the early-stage calcification examination of atherosclerosis in rabbits and effects of Pioglitazone in treating early-stage calcification.Material and Methods Sixteen New Zealand male rabbits were randomly divided into two groups:Pioglitazone group and control group,witheight rabbits in each group.Atherosclerosis model was established.Rabbits in Pioglitazone group received gavage with Pioglitazone and were raised with high-fat diet for 20 weeks.Blood was drawn to exam high sensitivity C-reactive protein and matrix metalloproteinase-9.PET/CT was used to measure mean standardized uptake value (SUVmean) and maximum standardized uptake value (SUVmax).Rabbit aorta received immunohistochemical,the plaque area,density of macrophage,percentage of calcification area and apoptosis index between the two groups were determined and compared.Results On 20 week,high sensitivity C-reactive protein in Pioglitazone group (4.27±0.43 vs.6.51 ±0.91,P<0.01),matrix metalloproteinase-9 (41.52± 1.99 vs.62.21 ±3.60,P<0.05),SUVmean (0.55±0.18 vs.0.68±0.21,P<0.01)and SUVmax (0.70±0.19 vs.0.82±0.30,P<0.05) were obviously lower than those in control group.Plaque area,density of macrophage,percentage of calcification area and apoptosis index in control group were obviously higher than those in Pioglitazone group.Plaque area of related artery section was positively correlated with SUVmean (r=0.28,P<0.01) and SUVmax (r=0.25,P<0.05).Density of macrophage was positively correlated with SUVmean (r=0.50,P<0.01) and SUVmax (r=0.46,P<0.01).Percentage of calcification area was positively correlated with SUVmean (r=0.50,P<0.01) and SUVmax (r=0.47,P<0.01).Apoptosis index was positively correlated with SUVmean (r=0.61,P<0.01)and SUVmax (r=0.60,P<0.01).Conclusion Inflammation and macrophage apoptosis are of great importance in the early-stage of atherosclerosis.18F-FDG PET/CT imaging can be used to assess minor calcification.Pioglitazone can reduce inflammatory level of atherosclerosis of the experimented animals,inhibiting early-stage calcification.