99Tc-MDP治疗强直性脊柱炎的临床疗效

目的：研究云克(锝[^99Tc]亚甲基二膦酸盐，^99Tc-MDP)治疗强直性脊柱炎(AS)的临床效果。方法：AS患者35例，分为2组，云克组20例静脉滴注云克1～4个疗程，每疗程总剂量1g．对照组15例应用非甾体抗炎药和甲氨喋呤治疗．治疗前后比较临床表现和实验室检测变化。结果：治疗10d后，云克组患者临床症状和实验室检测指标均有明显改善．有效率高于对照组，治疗效果与取得效果的时间均明显缩短。结论：云克治疗AS近期疗效明显，起效快，无明显副作用．远期疗效有待进一步研究。     

99Tc-MDP与伊班膦酸钠在恶性肿瘤骨转移骨痛中的临床应用

目的 评价99锝-亚甲基二膦酸盐(99Tc-MDP)与伊班膦酸钠治疗转移性骨肿瘤骨痛的疗效与安全性.方法 骨转移瘤伴中重度骨痛患者110例,按随机数字表法分为2组,分别应用99Tc-MDP与伊班膦酸钠治疗.依据WHO( 1989)年的评分标准评估患者治疗前后的疼痛和生活质量变化,观察疗效.结果 99Tc-MDP与伊班膦酸钠对比,二者治疗总有效率差异无统计学意义(79.66％vs74.51％,P＞0.05),不良反应发生率伊班膦酸钠明显高于99Tc-MDP(31.37％vs8.47％,P＜0.05).结论 99 Tc-MDP与伊班膦酸钠对骨转移瘤骨痛均有较好的辅助治疗作用,99Tc-MDP不良反应较轻.     

三乌胶丸联合锝[99Tc]亚甲基二膦酸盐注射液治疗类风湿性关节炎的临床观察

目的:观察三乌胶丸联合锝[~(99)Tc]亚甲基二膦酸盐注射液治疗类风湿性关节炎的临床疗效及安全性。方法:选取2019年10月7日～2020年5月7日收治的类风湿性关节炎患者120例,随机分为试验组与对照组,每组60例。对照组采用锝[~(99)Tc]亚甲基二膦酸盐注射液治疗,试验组采用三乌胶丸与锝[~(99)Tc]亚甲基二膦酸盐注射液联合用药。比较两组临床疗效、治疗前后的晨僵时间、关节肿胀个数、关节压痛数、关节疼痛程度评分、健康评定问卷评分。结果:试验组总有效率为93.33%,高于对照组的80.00%,差异有统计学意义,P<0.05;治疗后,两组晨僵时间、关节肿胀个数、关节压痛数均较治疗前减少,且试验组减少幅度较对照组大,差异均有统计学意义,P<0.05;两组治疗后关节疼痛程度评分、健康评定问卷评分均较治疗前降低,且试验组降低幅度更大,差异均有统计学意义,P<0.05;治疗期间两组患者均未出现不良反应。结论:应用三乌胶丸联合锝[~(99)Tc]亚甲基二膦酸盐注射液治疗类风湿性关节炎安全有效,可改善患者临床症状,降低疼痛程度,提高功能状态。     

锝[99Tc]亚甲基二膦酸盐治疗老年女性绝经后骨质疏松症的疗效和安全性分析

目的 分析锝[99Tc]亚甲基二膦酸盐治疗老年女性绝经后骨质疏松症的疗效和安全性.方法 选取2017年1月—2019年12月的绝经后骨质疏松症老年女性患者60例,以随机的方式分成对照组30例,观察组30例,对照组给予常规治疗,应用维生素D钙咀嚼片治疗,观察组在常规治疗同时应用锝[99Tc]亚甲基二膦酸盐治疗.比较两组的...     

99 TC-亚甲基二膦酸盐治疗类风湿性关节炎的临床观察

目的：对99TC－亚甲基二膦酸盐治疗类风湿关节炎（RA）的疗效和安全性进行临床观察。方法：67例RA患者经99TC－亚甲基二膦酸盐治疗，对其治疗前后关节肿胀指数，关节压痛指数，握力，晨僵时间，休息痛和血沉，C反应蛋白等临床指标进行比较同时观察记录副反应出现情况，监测肝肾功能等变化情况，对资料进行统计分析。结果；本组67例经99TC－亚甲基二膦酸盐治疗后，RA病情明显改善，除握力外其他各项临床指标改善均有统计学意义（P＜0．05），该药物临床总有效率80．60％，副反应发生率小且轻微，结论：99TC－亚甲基二膦酸盐是治疗RA的一种作用强安全性好的药物。     

99锝-亚甲基双膦酸盐联合钙剂治疗乳腺癌术后骨质疏松症疗效观察

目的观察99锝-亚甲基双膦酸盐联合碳酸钙D3及活性维生素D3治疗乳腺癌术后骨质疏松症的疗效和安全性。方法乳腺癌术后骨质疏松症患者130例均给予99锝-亚甲基双膦酸盐+碳酸钙D3+活性维生素D3治疗,比较治疗前及治疗1a后患者骨密度值及血清钙、磷、碱性磷酸酶、骨钙素、Ⅰ型胶原交联羧基末端肽、1,25-二羟维生素D3等水平变化。结果治疗后腰椎(L1-4)及左髋股骨颈、大转子及小转子骨密度均较治疗前增加(P<0.05);血清骨钙素水平较治疗前增高(P<0.05),Ⅰ型胶原交联羧基末端肽较治疗前下降(P<0.05);血清钙、磷、碱性磷酸酶及1,25-二羟维生素D3水平与治疗前比较差异无统计学意义(P>0.05)。结论 99锝-亚甲基双膦酸盐联合碳酸钙D3及活性维生素D3治疗乳腺癌术后骨质疏松症疗效满意。     

99锝-亚甲基双膦酸盐联合钙剂治疗乳腺癌术后骨质疏松症疗效观察

目的 观察99锝-亚甲基双膦酸盐联合碳酸钙D3及活性维生素D3治疗乳腺癌术后骨质疏松症的疗效和安全性.方法 乳腺癌术后骨质疏松症患者130例均给予99锝-亚甲基双膦酸盐+碳酸钙D3+活性维生素D3治疗,比较治疗前及治疗1 a后患者骨密度值及血清钙、磷、碱性磷酸酶、骨钙素、Ⅰ型胶原交联羧基末端肽、1,25-二羟维生素D3等水平变化.结果 治疗后腰椎(L1-4)及左髋股骨颈、大转子及小转子骨密度均较治疗前增加(P＜0.05);血清骨钙素水平较治疗前增高(P＜0.05),Ⅰ型胶原交联羧基末端肽较治疗前下降(P＜0.05);血清钙、磷、碱性磷酸酶及1,25-二羟维生素D3水平与治疗前比较差异无统计学意义(P＞0.05).结论 39锝-亚甲基双膦酸盐联合碳酸钙D3及活性维生素D3治疗乳腺癌术后骨质疏松症疗效满意.     

^99锝-亚甲基双膦酸盐联合钙剂治疗乳腺癌术后骨质疏松症疗效观察

目的观察^99锝-亚甲基双膦酸盐联合碳酸钙D。及活性维生素D。治疗乳腺癌术后骨质疏松症的疗效和安全性。方法乳腺癌术后骨质疏松症患者130例均给予”锝一亚甲基双膦酸盐＋碳酸钙D3＋活性维生素D3治疗,比较治疗前及治疗1a后患者骨密度值及血清钙、磷、碱性磷酸酶、骨钙素、Ⅰ型胶原交联羧基末端肽、1,25-二羟维生素D。等水平变化。结果治疗后腰椎（L1-4）及左髋股骨颈、大转子及小转子骨密度均较治疗前增加（P〈0．05）;血清骨钙素水平较治疗前增高（P〈0．05）,Ⅰ型胶原交联羧基末端肽较治疗前下降（P〈0．05）;血清钙、磷、碱性磷酸酶及1,25-二羟维生素D3水平与治疗前比较差异无统计学意义（P〉0．05）。结论^99锝-亚甲基双膦酸盐联合碳酸钙D3及活性维生素D3治疗乳腺癌术后骨质疏松症疗效满意。     

99锝-亚甲基二膦酸盐配合康复训练治疗强直性脊柱炎疗效观察

目的^99锝-亚甲基二膦酸盐（云克）配合康复训练治疗强直性脊柱炎的疗效。方法118例强直性脊柱炎患者随机分为治疗组58例和对照组60例，治疗组除常规给予美洛昔康和柳氮磺吡啶外，静脉推注云克配合康复训练；对照组仅给予美洛昔康和柳氮磺吡啶，观察两组患者治疗前后相关临床和实验室指标的变化。结果经过2个疗程治疗，治疗组在缓解关节疼痛、缩短晨僵时间、改善脊柱活动度、降低急性炎症指标ESR、CRP和PLT以及免疫球蛋白IgM等方面均优于对照组（P〈0．05～0．01），且无明显副作用。结论云克配合康复训练治疗强直性脊柱炎疗效明显。     

~(99m)Tc-MDP全身骨显像心包显影1例

患者,男,49岁。因“咳嗽、咳痰10余天”行胸部X-CT提示“右下肺占位”,纤支镜确诊为右肺鳞癌,行右下肺叶切除术及淋巴结清扫术,术中见右下肺10cm&#215;8cm&#215;8cm肿块,术后病理示右肺下叶鳞癌,肺门淋巴结转移。术后1个月予以NP(长春瑞滨+顺铂)方案化疗,化疗中并发肺部霉菌感染,经积极抗霉菌治疗后缓解。术后2个月感胸闷气促,全身酸痛行99mTc-MDP全身骨显像。静脉注射99mTc-MDP25mCi3.5小时后行全身骨显像示:全身骨骼显影清晰,右侧第6后肋手术处骨中断并见点状积聚影,胸部肋骨影中心脏部位见一环形放射性浓聚影,呈靴状,胸部SPECT断层显像结果相同,考虑心包积液征象(图1、2)。复查胸部CT提示肺癌术后改变,右侧胸腔、心包少量积液;心电图提示窦性心动过速(心率146次/分),T波:aVF低平,Ⅲ倒置;心脏B超示心包积液(右室前深1.4cm),左心输出功能降低;心肌酶谱AST62.3I U/l,LDH253I U/l,肌酸激酶同工酶30.3I U/l。积极治疗1周后复查心脏B超未见明显心包积液,心肌酶谱均正常,胸闷、气急较前改善。讨论放射性核素全身骨显像已广泛应用于临床,且骨显像时骨外组织摄取骨...     

Serum bone sialoprotein: a marker of bone resorption in postmenopausal osteoporosis

Thirty healthy perimenopausal women who had normal lumber spine bone mineral density (LS-BMD) measured by dual energy X-ray absorptiometry (DEXA) participated in this study as controls. The pathological group comprised 50 postmenopausal osteoporotic women who had LS-BMD more that 2 SD below the normal mean of healthy perimenopausal women. Postmenopausal osteoporotic patients were allocated to three different therapeutic modalities (hormone replacement therapy HRT, alendronate or combined HRT and alendronate). Blood and urine samples were collected from all groups before and 12 months after treatment. Serum bone sialoprotein (BSP) was measured by a specific radioimmunoassay and urinary pyridinoline N-telopeptide of type l collagen (NTX ) were determined as biomarkers of bone resorption. In addition, serum IL-11 and TGF &#103 2 were measured by enzyme immunoassays. The results obtained showed that serum BSP was significantly elevated in postmenopausal osteoporosis compared to that of healthy perimenopausal controls. Significant positive correlations exist between serum BSP and biomarkers of bone resorption (Pyr,DPyr,NTX ) as well as bone resorptive cytokines (IL-11,TGF &#103 2 ). Serum BSP decreased after different antiresorptive treatments and this decrease paralleled the decrease of bone resorption markers and the increase of LS-BMD. Based on these data, circulating BSP appears to be a valuable marker of bone resorption and monitoring therapy with antiresorptive drugs in postmenopausal osteoporosis. (Pyr), deoxy-pyridinoline (DPyr) and     

^99mTc—MDP骨因子分析显像、骨三相显像主骨断层显像对股骨头缺血性坏死诊断的比较

目的：寻找对早股骨头缺血性坏死更有效的诊断方法。方法：选择10例（20个髋）正常人和28例（35个髋）股骨头缺血性坏死（FHIN）患者分别进行骨因子分析显像、骨三相显像和骨断层显像,得到3组结果并将3组结果进行对比分析。结果：对Ⅰ、Ⅱ期FHIN患者诊断的灵敏度以^99mTc-MDP骨因子分析显像最高,为76．4％,骨断层显像为52．9％,骨三相显像35．29％,骨因子分析与骨三相相比有显著性差异（P＜0．05）,而3者对Ⅲ期以上FHIN诊断的灵敏度基本一致,结论^99mTc-MDP骨因子分析显像在FHIN早期诊断和病情评估方面比骨三相显像和骨断层显像更有价值。     

绝经后女性血清鸢尾素、25羟维生素D水平与骨代谢、骨质疏松的相关性

目的观察绝经后女性血清鸢尾素(Irisin)、25羟维生素D [25(OH)D]水平与骨代谢、骨密度(bone mineral density,BMD)、骨质疏松的相关性。方法选择2018年1月至2020年1月在河南科技大学第二附属医院健康中心体检的年龄>45岁的绝经后女性为研究对象,分为骨质疏松组(n=370)和非骨质疏松组(n=321),检测血生化、血清鸢尾素、25(OH)D、I型前胶原氨基端肽(procollagen typeⅠN-terminal propeptide,P1NP)和1型胶原羧基端肽β特殊序列(beta C-terminal cross-linked telopeptides of type icollagen,β-CTX)骨代谢指标,测量BMD,计算四肢骨骼肌指数(ASMI),并统计分析。结果绝经后女性骨质疏松组的鸢尾素[(16.53±4.46)ng/mL VS(20.32±4.52)ng/mL,P <0.001]和25 (OH)D [(23.66±5.46)ng/mL VS(31.42±4.93)ng/mL,P <0.001]水平均低于非骨质...     

绝经后骨质疏松症患者性激素、细胞因子及骨代谢指标的变化及关系

目的探讨绝经后骨质疏松症(POP)患者性激素、细胞因子及骨代谢指标的相关性。方法根据腰椎骨密度(BMD)扫描结果将受试者分为3组,即POP组48例、绝经后非骨质疏松(NOP)组32例及绝经前健康对照组30名;采用放射免疫法、化学发光法及酶联免疫吸附试验(ELISA)测定110例受试者血清雌二醇(E2)、白细胞介素-6(IL-6)、胰岛素样生长因子-1(IGF-1)、骨碱性磷酸酶(BAP)及氨基端中段骨钙素(N-BGP)的水平,并进行相关性分析。结果 POP组患者血清IL-6、N-BGP及BAP水平增高,高于NOP组及正常对照组(P<0.01),而BMD和E2、IGF-1的水平则低于NOP组及正常对照组(P<0.01);IGF-1与BMD、E2呈显著正相关(r=0.572、0.436,P<0.01),与年龄呈显著负相关(r=-0.541,P<0.01);IL-6与BMD、E2呈负相关(r=-0.584、-0.435,P<0.05),与N-BGP、BAP呈正相关(r=0.546、0.354,P<0.05);BMD与IL-6、年龄、N-BGP、BAP呈负相关(P<0.05),与E2、IGF-1呈正相关(P<0.05)。结论 POP患者IL-6、N-BGP、BAP、E2及IGF-1水平可作为临床诊治POP的辅助指标。     

不同功能活动对老年人群下肢成骨指数的影响

目的 评估不同功能活动对老年人下肢成骨指数(OI)的影响,并探讨适合老年人群且有助于其骨骼健康的运动方式.方法 共选取健康老年人20例,每一位受试者根据抽签结果按照随机顺序进行以下4项训练,分别是单腿踏板、坐位到站位、原地跳起及原地踏步训练,同时计算每位受试者在进行上述运动时的OI值.OI值=最大地面反作用力(peakGRF)/(体重×9.8)×In(重复训练次数±1).结果 原地跳起时OI值(7.52±2.06)和原地踏步时OI值(6.51±1.59)均显著高于单腿踏板时OI值(5.22±0.63)(P＜0.05),坐位到站位训练时OI值(2.23±0.42)最小.通过相关性分析发现,受试者原地跳起时的高度及原地踏步时脚抬起的高度与OI值间均无明显相关性(P＞0.05).结论 单腿踏板及原地踏步均有较高的OI值,这两种功能活动均适用于老年人群并有助于其骨骼健康.     

99Tcm-MDP骨显像评价异体骨移植的价值

目的　研究99Tcm MDP骨显像评价异体骨移植的意义。方法　于 18只新西兰大白兔两侧桡骨干处造成 15mm缺损 ,随机分为A、B两组 ,A组植入碱性成纤维细胞生长因子 (bFGF)与异体冻干骨的复合物 ,B组单纯植入冻干骨。于术后 2 ,4,6周行放射性核素骨显像、组织学切片和X线检查。并另选 3只大白兔作为正常对照。结果　①未出现并发症的移植骨均存活 ,它们的放射性浓度在术后 2周增加 ,4周达高峰 ,以后逐渐下降 ,其动态变化与组织形态学改变一致并早于X线改变。②A组的放射性浓度始终高于B组。③另有 2例术后感染 ,在 2周时放射性浓度下降 ,经治疗后 ,恢复正常。结论　放射性核素骨显像可早期动态观察移植骨的存活情况并评价新型植骨材料的成骨活性     

Association of physical performance measures with bone mineral density in postmenopausal women

OBJECTIVE: To investigate the association between physical performance measures and bone mineral density (BMD) in older women. DESIGN: Cross-sectional analysis. SETTING: University research laboratory. PARTICIPANTS: Healthy postmenopausal women (N=116; mean age +/- standard deviation, 68.3+/-6.8y) in self-reported good health who were not taking medications known to affect bone, including hormone replacement therapy. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Anthropometrics and BMD of the hip, spine, whole body, and forearm. Physical performance measures included normal and brisk 8-m gait speed, normal step length (NSL), brisk step length (BSL), timed 1-leg stance (OLS), timed sit-to-stand (STS), and grip strength. RESULTS: NSL, BSL, normal gait speed, brisk gait speed, OLS, and grip strength correlated significantly with several skeletal sites ( r range, .19-.38; P <.05). In multiple regression models containing body mass index, hours of total activity, total calcium intake, and age of menarche, NSL, BSL, normal and brisk gait speeds, OLS, and grip strength were all significantly associated with BMD of various skeletal sites (adjusted R 2 range, .11-.24; P <.05). Analysis of covariance showed that subjects with longer step lengths and faster normal and brisk gait speeds had higher BMD at the whole body, hip, and spine (brisk speed only). Those with a longer OLS had greater femoral neck BMD, and those with a stronger grip strength had greater BMD in the whole body and forearm ( P <.05). STS was not related to any skeletal site. CONCLUSIONS: Normal and brisk gait speed, NSL, BSL, OLS, and grip strength are all associated with BMD at the whole body, hip, spine, and forearm. Physical performance evaluation may help with osteoporosis prevention and treatment programs for postmenopausal women when bone density scores have not been obtained or are unavailable.     

The effect of MRI contrast agents on hepatic and splenic uptake in the rabbit during 99mTc‐MDP bone scintigraphy

The objective of this study was to investigate the effects of Omniscan® and Magnevist® on ^99mTc‐MDP uptake in rabbits during ^99mTc‐MDP bone scintigraphy. In Experiment Group 1, 30 healthy adult rabbits were randomized into six subgroups (n = 5); each subgroup experienced a different time interval between injections (30 min, 60 min, 120 min, 240 min, 360 min, 24 h). All six subgroups were injected first with Omniscan®, then with ^99mTc‐MDP. After 7 days, the same six subgroups were injected with normal saline followed by ^99mTc‐MDP at the same time intervals. In Experiment Group 2, 20 healthy adult rabbits were allocated randomly to four subgroups (n = 5); each subgroup experienced a different time interval between injections (30 min, 60 min, 120 min, 240 min). All four subgroups were injected first with Magnevist®, then with ^99mTc‐MDP. After 7 days, the same four subgroups were injected with normal saline followed by ^99mTc‐MDP. In all experiments, whole‐body skeletal imaging was performed. Liver, spleen, and background were delineated to determine the target‐to‐background (T/B) ratio. Diffusely increased intake of the imaging agent was seen in the liver and spleen when the injection‐time interval between Omniscan® and ^99mTc‐MDP varied from 30 min to 240 min and when the time interval between Magnevist® and ^99mTc‐MDP was 30 min–60 min. The imaging findings are consistent with the results of L/B and S/B ratios in each experiment group. Both Omniscan® and Magnevist® have an effect on ^99mTc‐MDP uptake during bone scanning; the main effect is diffusely increased hepatic and splenic activity. Copyright © 2015 John Wiley & Sons, Ltd.     

云克治疗绝经后2型糖尿病合并骨质疏松症的疗效研究

目的 探讨云克(锝亚甲基二磷酸盐针剂)治疗绝经后2型糖尿病患者合并骨质疏松症疗效观察.方法 诊断明确的绝经后2型糖尿病合并骨质疏松症患者59例随机分为治疗组和对照组,治疗组综合治疗基础上应用锝亚甲基二膦酸盐针剂联合口服钙尔奇D片、骨化三醇胶丸,对照组口服钙尔奇D片、骨化三醇胶丸.结果 治疗组6个月后骨密度不同程度增加,临床症状改善,总有效率93.5％,差异有统计学意义(P＜0.05).结论 云克治疗绝经后2型糖尿病合并骨质疏松症安全有效.     

Tc-99m MIBI uptake in traumatic vertebral fractures and metastatic vertebral lesions: Comparison with Tc-99m MDP

This study compared technetium-99m-hexakis-2-methoxyisobutyl-isonitrile (Tc-99m MIBI) with technetium-99m methylene diphosphonate (Tc-99m MDP) to determine whether Tc-99m MIBI could distinguish vertebral metastases from traumatic vertebral fractures. Twenty patients with traumatic vertebral fracture (and no malignant disease) and 14 patients with metastatic vertebral lesions were evaluated. Three to 4 hours after intravenous injection of Tc-99m MDP, images of the vertebrae in all patients were obtained. Corresponding Tc-99m MIBI images were acquired within 4 days after the Tc-99m MDP bone images were obtained. Computed tomography and magnetic resonance imaging demonstrated 24 vertebral traumatic fractures and 44 vertebral metastases. On conventional bone scans, Tc-99m MDP activity was increased in 92% of vertebral fractures and in 100% of vertebral metastases. However, on MIBI scans, no abnormal findings were observed in the vertebrae with fracture, although increased activity was seen in 73% of vertebral metastases. In this study, traumatic vertebral fractures tended to display no pathologic increases in Tc-99m MIBI uptake, whereas bone metastases usually appeared with high uptake. In light of the excellent specificity of Tc-99m MIBI scans compared with Tc-99m MDP bone scans, imaging studies that use Tc-99m MIBI scans may play an important complementary role in differentiating vertebral metastases from traumatic vertebral fractures.