血液病外周性及中心性骨髓SPECT显像规律初探

目的：探讨各种血液病单光子发射电子计算机断层扫描(SPECT)骨髓显像的特点及其规律。方法：对148例不同类型血液病患者，包括再生障碍性贫血(再障)72例，白血病32例，骨髓增生异常综合征(MDS)20例，缺铁性贫血14例，慢性溶血性贫血(慢性溶贫)l0例，静脉注射^99mTc—植酸钠后进行全身骨髓SPECT显像，观察外周及中心骨髓活性及分布情况。结果：148例受检者中，外周骨髓扩张率为44．6％，其中再障未缓解期与缓解期分别占28．6％和39．1％；白血病未缓解期与缓解期分别占78．6％和33．3％；缺铁性贫血占21．4％，慢性溶贫占80．0％，MDS占75．0％。几种血液病骨髓扩张的好发部位不同，再障与白血病患者处于不同临床阶段，中心骨髓活性受抑制程度不同，分别是未缓解期再障73．5％，白血病71．4％，缓解期再障43．5％，白血病27．8％，同类两者间比较差异均有显著性意义(P＜0．05)。20例MDS患者中有13例显示中心骨髓处于高活性状态。结论：了解不同血液病外周及中心骨髓活性及分布的特点和规律，有助于其诊断及疗效的监测。

The preliminary study of peripheral and central bone marrow scintigraphy in hematological diseases

Objective:To investigate the features and regularity of SPECT bone marrow scintigraphy in various hematological diseases. Method: Bone marrow scintigraphy using 99m Tc-sodium phytate was analysed in 148 patients, including 72 cases of aplastic anemia (AA), 32 of leukemia (LA), 20 of myelodysplasia syndrome (MDS), 14 of iron deficiency anemia (IDA) and 10 of chronic hemolytic anemia (CHA). Result:Of the 148 patients the total expansion rate of peripheral bone marrow (PBM) was 44. 6%, including 28. 6% in non-remission and 39. 1% in remission of AA respectively, 78. 6% in non-remission and 33. 3% in remission of LA, 21. 4% in IDA, 80. 0% in CHA and 75.0% in MDS. The expansion predilections of various hematological diseases were different. The suppression degree of central bone marrow (CBM) activity differed significantly between the non-remission and remission stage 73. 5% in AA and 71. 4% in LA during non-remission stage,43. 5% in AA and 27. 8% in LA during remission stage. The activity of CBM was high in 13/20 MDS patients. Conclusion: The features and regularity of PBM expansion and CBM activity imaging can be used to diagnose and evaluate the therapeutic effect of various hematological diseases.