门脉高压症患者自体脾移植前后脾显像的临床应用价值

Evaluation of Radionuclide Spleen Imaging after Spleen-Preserving Operation for Portal Hypertension Patients

目的门脉高压症自体脾移植前后行99Tcm-植酸钠胶体肝脾显像,探讨其对移植脾成活及其功能状态的评价作用。方法经临床及实验室检查排除肝脾及血液系统疾病的正常人20例,计划行自体脾移植术的门脉高压脾功能亢进患者24例,所有入选者均行99Tcm-植酸钠胶体肝脾显像,门脉高压患者于术前及术后1年分别进行肝脾显像,以肝组织、脾脏最"热"点为中心选取感兴趣区,计算前位和后位肝脾计数比值,进行半定量分析。结果所有入选者肝脾显影清晰,门脉高压脾功能亢进患者术前肝脾平均计数比值明显降低(t=11.8,P<0.01),经自身脾移植术后该比值可再度回升(t=9.5,P<0.01),但未达到正常水平(t=6.9,P<0.01),说明该方式治疗门脉高压脾功能亢进总体上是有效的。结论自体脾移植是解除门脉高压症的有效措施,99Tcm-植酸钠胶体肝脾显像是检测保留性脾手术后脾脏成活及功能状况的有效方法。

Objective To investigate the value of ^99Tc^m-PHT spleen imaging for the portal hypertension patients who were to have spleen-preserving operation. Methods Twenty normal persons and 24 patients with portal hypertension were included. ^99Tc^m-PHT spleen imaging was made for all the normal persons and patients before spleen-preserving operation and 1 year after that. Semi-quantitative analysis was done on ^99Tc^m-PHT spleen images. Results The liver/spleen ratios of patients before operation were much lower than that of normal persons（ t = 11.8 ,P 〈0. 01 ）. The liver/spleen ratios were increased after operation（ t = 9.5,P 〈 0.01 ）. But the ratios were not as higher as normal persons （t =6.9,P 〈 0.01 ）. Conclusion Spleen-preserving operation is superior for the portal hypertension. ^99Tc^m-PHT spleen imaging is a most effective method for the portal hypertension patients to illuminate the function of spleen and its survival through spleen-preserving operation.