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^(99m)Tc-亚甲基二磷酸全身骨关节显像在炎性关节病诊断中的意义

Role of ^(99m)Tc-MDP in whole body ECT for diagnosis of inflammatory arthropathy
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摘要 目的:观察99mTc-亚甲基二磷酸(MDP)全身骨关节显像(ECT)在不同炎性关节病显像中的差别,结合临床资料研究其临床价值。方法:收集45例活动期炎性关节病患者,其中类风湿关节炎(RA)21例、血清阴性脊柱关节病(SPA)10例、未分化关节炎(UA)5例、骨关节炎(OA)5例、痛风性关节炎(GOUT)4例。记录患者的关节肿胀数(SJC)、关节压痛数(TJC)、红细胞沉降率(ESR)、C反应蛋白(CRP)、铁蛋白(SFe)及RA患者的类风湿因子(RF)、抗环状瓜氨酸肽抗体(抗CCP抗体)。记录所有患者的ECT关节浓聚个数。结果:RA组ECT阳性率(95.2%)高于非RA组(66.7%)(χ2=4.07,P<0.05)。RA患者ECT浓聚关节个数与临床SJC及TJC呈明显正相关(r分别为0.921、0.875,P<0.001),ECT阳性率与RF、抗CCP抗体增高阳性率差异有显著性(χ2分别为5.559和6.929,P<0.05)。结论:99mTc-MDP全身骨关节显像可以发现炎性关节病患者受累关节部位,是判断炎症程度的指标之一,同时对于血清阴性的RA具有一定的诊断价值。 Objective:To investigate the clinical significance and variation of applying technetium methylenediphosphonate injection(99mTc-MDP) to bone emission computed tomography(ECT) in diagnosis of inflammatory arthropathy.Methods: 99mTc-MDP ECT was performed in 45 patients with active inflammatory arthropathy,21 rheumatoid arthritis(RA),10 seronegative spondy loarthropathies(SPA),5 undifferentiated arthritis(UA),5 osteoarthritis(OA) and 4 gouty arthritis(GOUT).Recorded in all patients were the swollen joint counts(SJC),tender joint counts(TJC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),levels of serum feritin(SFe) and rheumatoid factor(RF) in RA as well as nticyclic citrullinated peptide antibody(anti-CCP antibody) besides the shiny joint counts in ECT for later assessment.Results: Positive effect of ECT was 95.2% for RA patients compared to 66.7% for non-RA(χ2=4.07,P0.05).The shiny joint counts were positively correlated with SJC and TJC(r=0.921,r=0.875,respectively,P0.001),and the positive rates of ECT were higher than that in RF and CCP antibodies(χ2=5.559,χ2=6.929,respectively,P0.05).Conclusion: 99mTc-MDP ECT may expose the joint lesion involvements in patients with inflammatory arthropathy,and the agent dosage is an important index for estimation of the inflammation,specially for those of serum-negative RA cases.
出处 《皖南医学院学报》 CAS 2012年第5期372-374,共3页 Journal of Wannan Medical College
基金 院中青年科研基金项目(WK200913F)
关键词 99mTc-亚甲基二磷酸 骨关节显像 炎性关节病 99mTc-MDP ECT inflammatory arthropathy
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