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心肌是人体内代谢最旺盛的组织之一,它可利用葡萄糖、脂肪酸、乳酸及酮体等多种底物产生ATP,满足细胞的能量需求。各种底物的利用占比受多种因素的影响,在空腹状态下,心肌细胞以脂肪酸代谢为主,而餐后在糖负荷状态下则以葡萄糖代谢为主。心肌代谢的异常改变与多种心脏疾病相关,如心肌缺血和心力衰竭等[1]。因此,评价心肌代谢状态对于心脏疾病的诊断、评估和治疗策略的制定均具有重要的作用和临床价值。放射性核素心肌代谢显像作为一种无创性诊断方法,在评价心肌能量代谢方面具有独特的优势[2-3]。它通过放射性核素标记心肌细胞能量代谢底物进行显像,辅以量化分析以评价心肌细胞的代谢状态。由于临床常用的正电子核素多为机体组成元素的同位素,如11C、13N、15O、18F等,其标记物能真正反映或模拟人体内的生化代谢过程,且PET具有图像分辨率高,可以动态、定量测量等优势,因此,正电子核素显像剂在临床及科研中的应用非常广泛。目前,根据临床用途可将正电子核素心肌代谢显像剂分为氧代谢显像剂、糖代谢显像剂和脂肪酸代谢显像剂[4]。
正电子核素心肌代谢显像剂的研究进展
Research progress of positron radionuclide myocardial metabolism imaging agents
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摘要: 心肌细胞利用葡萄糖、脂肪酸、乳酸及酮体等多种底物产生能量,以维持自身的正常舒缩功能。心肌细胞能量代谢的异常改变与多种心脏疾病相关,如心肌缺血和心力衰竭等。放射性核素显像作为一种无创性功能检查方法,能够用于心肌细胞代谢状况的评价。放射性核素心肌代谢显像剂是由放射性核素标记的心肌代谢底物及其类似物,在临床上分为氧代谢显像剂、糖代谢显像剂和脂肪酸代谢显像剂。笔者就近年来有关正电子核素心肌代谢显像剂的研究进展进行综述。Abstract: Cardiomyocytes use various substrates such as glucose, fatty acids, lactic acid, and ketone bodies to produce energy to maintain their normal systolic and diastolic function. Abnormal changes in cardiomyocytes' energy metabolism are associated with various heart diseases, such as myocardial ischemia and heart failure. As a non-invasive functional examination method, radionuclide imaging can be used to evaluate the metabolism status of cardiomyocytes. Radionuclide myocardial metabolism imaging agents are myocardial metabolism substrates. Their analogues are labeled with radionuclides, divided into oxygen metabolism imaging agents, glucose metabolism imaging agents, and fatty acid metabolism imaging agents. This paper reviews the research progress of positron radionuclide myocardial metabolism imaging agents in recent years.
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Key words:
- Radionuclide imaging /
- Positron imaging agent /
- Myocardial metabolism
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