摘要
目的 探讨核素骨关节显像对早期和活动期类风湿关节炎 (RA)诊断价值。方法 对 31例确诊为RA患者进行99mTC -羟基亚甲基二磷酸 (MDP)全身骨关节显像检查 ,全部RA患者根据关节疼痛部位摄X线平片 ,同时进行血沉 (ESR)、血清C反应蛋白 (CRP)、类风湿因子 (RF)滴度、关节压痛指数 (JTI)、关节肿胀指数 (JSI)测定。结果 31例RA患者骨显像阳性 2 9例 ,诊断符合率 93 5 %,而非RA关节炎 (AS和OA)组和正常人组核素骨关节显像率分别为 80 0 %和 10 5 %;在 2 2 6个有临床表现的关节中 ,核素显像阳性是 2 0 1个 ,总符合率为88 9%;在 2 0例早期RA(≤ 2年 )中 ,核素骨关节显像率 95 0 %,X线片RA改变符合率 2 0 0 %;病变关节摄取示踪剂程度与JTI、JSI、ESR、CRP呈正相关 (r为 0 4 5~ 0 5 2 ,P <0 0 5 )。结论 99mTC骨关节显像为骨关节无创伤性、功能性、灵敏度高但特异性不强的检查方法 ,结合临床症状、体征及血清免疫学改变 ,对提高早期和活动期RA的诊断及评估有帮助。
Objectives To investigate the clinic value of 99 Tc-MDP in the diagnosis of rheumatoid arthritis(RA).Methods The whole body bone imaging of 99 Tc-MDP were performed in 31 patients with RA and 20 controls with other arthritis(AR group) and 19 normal controls.X-ray,rheumatoid factor(RF),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),joint tender index and joint swollen index were detected in RA patients.Results Abnormal bone images were observed in 29 out of 31 patients, with a 93.5 % of coincidence in RA group, 80% and 10.5% of in AR group and normal group. 201 out of 226 (88.9%) patients with joint symptoms showed abnormal bone images. 95% abnormal bone image rate and 20% abnormal X ray rate were found in 20 early RA patients. The joint radiopharmaceutical uptake score correlated positively with JTI, JSI, CRP and ESR. Conclusions 99m Tc MDP bone imaging is a sensitive, functional, noninvasive but unspecific method in detecting RA. And in combination with clinical symptoms, signs and serological changes, it is of value to the diagnosis of early RA.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2002年第5期277-278,共2页
Chinese Journal of Practical Internal Medicine