肥大性骨关节病骨扫描及临床因素配对分析

Bone scan features of hypertrophic osteoarthropathy and paired analysis of clinical factors

目的探讨肥大性骨关节病单光子发射型计算机成像-全身骨扫描影像表现及相关临床指标。方法从该院骨扫描检查病例中筛选肥大性骨关节病(HOA)患者30例,按性别、年龄、病理类型配对筛选对照组30例;比较表皮生长因子受体(EGFR)基因突变、吸烟年支数、血小板计数(PLT)、癌胚抗原、神经特异性烯醇化酶、细胞角化蛋白19片段、碱性磷酸酶(AKP)、乳酸脱氢酶、C反应蛋白(CRP)、血钙、血磷及血清钙磷比差异。结果 HOA组(30例)和对照组(成功配对26例)EGFR基因突变率分别为52.9%及47.1%;HOA组PLT、AKP、CRP水平明显高于对照组,差异均有统计学意义(P<0.05),而血清钙磷比低于对照组,差异也有统计学意义(P<0.05)。结论骨扫描诊断HOA具有识别性很高的特征性表现,HOA患者PLT明显增高,支持血小板及血小板源性细胞因子与HOA发生有关的假说。

Objective To probe the SPECT bone scan performance of hypertrophic osteoarthropathy and clinical indicators related to the pathogenesis of HOA.Methods Cases of HOA were selected from those who accepted SPECT bone scan,paired samples were matched by sex,age and pathological patterns.The differences of epidermal growth factor receptor(EGFR)gene mutation,annual number of cigarettes,blood platelet(PLT),carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),CYFRA,alkaline phosphatase(AKP),lactate dehydrogenase(LDH),C-reactionprotein(CRP),serum calcium,serum phosphate,and calcium-phosphorus ratio were compared between the HOA group and the paired group.Results EGFR gene mutation rate of HOA group(n=30)and paired group(n=26)were 52.9%and 47.1%,respectively.Levels of PLT,AKP activity and CPR of HOA group were significantly higher than the paired group,and the differences were statistically significant(P<0.05).However,the calcium-phosphorus ratio of HOA group was significantly lower(P<0.05).Conclusion Bone scan performance of HOA is highly characteristic.The level of PLT in HOA group increased significantly,which supports the hypothesis that the pathogeny of HOA relates to platelet and platelet-derived cytokines.