纳米碳负显像结合^(99m)Tc-MIBI术中定位甲状旁腺的研究

Research for intraoperative localization of parathyroid gland using nanocarbon imaging combined with ^(99m)Tc-MIBI

目的:探索甲状旁腺功能亢进手术中运用纳米碳混悬液和低剂量^(99m)Tc-MIBI定位旁腺的临床应用。方法:将44例继发性肾性甲状旁腺功能亢进患者随机分为3组,即低剂量^(99m)Tc-MIBI+纳米碳(组Ⅰ)、高剂量^(99m) Tc-MIBI+纳米碳(组Ⅱ)、对照组(组Ⅲ)。比较其术前术后甲状旁腺激素(PTH)、血钙、术中甲状旁腺同位素放射量等实验数据。采用t检验和方差分析进行统计学处理。结果:术后PTH组Ⅰ为(23.8±32.4)ng/L,组Ⅱ为(15.8±18.2)ng/L,组Ⅲ为(90.1±139.4)ng/L,组Ⅰ与组Ⅱ均明显小于组Ⅲ,差异有统计学意义(P<0.05),组Ⅰ与组Ⅱ之间差异无统计学意义(P>0.05)。3组术中甲状旁腺的体内、体外放射量对比无明显差异。结论:纳米碳+^(99m)Tc-MIBI对继发性甲状旁腺手术有重要的定位价值,而低剂量的^(99m)Tc-MIBI可以减低患者的费用、降低辐射,同时可以达到相同的应用结果。

Objective：To explore the clinical application of nanocarbon（NC）suspension liquid combined with low dose of ^（99m）Tc-MIBI for parathyroid localization in the hyperparathyroidism surgery.Method：Forty-four patients with secondary hyperparathyroidism（SHPT）in the department of head-neck surgery of Renji Hospital,affiliated to Shanghai Jiaotong University,School of Medicine,were enrolled and randomized into 3groups including low-dose ^（99m）Tc-MIBI＋ NC group Ⅰ,high-dose ^（99m）Tc-MIBI＋ NC group Ⅱ,and control group Ⅲ.We compared the level of PTH,serum calcium before and after operation,and the intraoperative amount of radioactive isotopes of parathyroid gland,etc.Use t-test and Anova for statistical processing.Result：After operation,the PTH levels in group Ⅰ,Ⅱ,Ⅲ were（23.8±32.4）ng/L,（15.8±18.2）ng/L,（90.1±139.4）ng/L,respectively（groupⅠ vsⅢ,P〈0.05;group Ⅱ vsⅢ,P〈0.05,group Ⅰ vsⅡ,P〉0.05）.The intraoperative amount of radioactive isotopes of parathyroid gland had no significant difference among groupⅠ,groupⅡand groupⅢ.Conclusion：Nanocarbon combined with ^（99m）Tc-MIBI for SHPT surgery has important localization value.And low dose of 99 mTcMIBI can reduce the cost and radiation,which can achieve the same outcome for patients.