^(99m)Tc-植酸钠肝脾显像在脾功能亢进中的临床价值

Clinical Value of ^(99m)Tc- Phytate Scintigraphy in Hypersplenism

目的探讨^(99m)Tc-植酸钠肝脾显像在脾功能亢进诊断中的临床价值。方法实验组:49例临床诊断脾功能亢进患者,排除肝占位性病变。其中男19例,平均年龄(40.2±15.1)岁;女30例,平均年龄(40.44±18.26)岁;对照组:30例脾功能正常者,其中男17例,平均年龄(44.07±16.22)岁;女13例,平均年龄(47.8±12.08)岁。分别统计两组(后位)脾计数与(前位)肝计数,阳性标准设定:脾肝比值>50%为脾亢;20%<脾肝比值<50%为脾功能活跃(重度活跃:40~50%;中度活跃:30~40%,轻度活跃20-30%);脾肝比值<20%为脾功能正常,对两组数据进行对比分析。结果两组间脾肝比值具有显著性差异(P<0.05)。其中实验组中脾功能亢进30例,脾功能重度活跃9例,脾功能中度活跃5例,轻度活跃4例,脾功能正常1例。结论 ^(99m)Tc-植酸钠肝脾显像在显示脾脏形态的同时可根据放射性胶体颗粒在脾脏内的聚集程度进行功能评价并分级,检查方法简单,操作方便,无创伤,可作为临床判定脾功能的常规检查手段。

Objective To analyze the clinical significance of 99mTc - phytate scintigraphy in the patients with hyperthyroidism. Methods The Experimental group： 49 cases of clinical diagnosis of patients with spleen function, excluding B ultrasound hint liver diffuse change（liver cirrhosis, fatty liver）, 19 cases were male patients, the average age was （40.2 ± 15.1）; 30 cases were female patients, the average age was （40.44 ±18.26）. The Control group： 30 cases of splenic function in normal subjects, including 17 cases of male average age （44.07 ± 16.22）, female 13 cases average age（47.8 ± 12.08）. Statistics of two groups of the spleen（posterior） count and liver （anterior） count. Positive standard setting： spleen liver ratio 〉50% for hypersplenism; 20% 〈 spleen and liver ratio 〈50% of spleen function active（severe active： 40-50%; moderate active 30-40%, mild active 20-30%）; the ratio of less than 20% for spleen and liver function were normal spleen, two groups of data were compardd. Results The spleen and liver ratio were significantly different between the two groups （P〈 0.05）. 30 cases were hyperthyroidism in the experimental group, 9 cases were splenic functuion severe active, 5 cases were splenic function moderate active, 4 cases were splenic function mild active, and 1 case was splenic function normal. Conclusion 99mTc - phytate scintigraphy according to the degree of aggregation of sodium phytate and colloidal particles in the spleen in the functional evaluation and further classification, inspection method is convenient, non-invasive, can be used as a routine clinical examination to determine the function of spleen.