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99Tcm-MDP骨显像在类风湿关节炎骨痛中的应用
引用本文:高海燕,赵德善,张宝牛,刘炯,梁宏伟.99Tcm-MDP骨显像在类风湿关节炎骨痛中的应用[J].中国医学影像技术,2014,30(7):1058-1062.
作者姓名:高海燕  赵德善  张宝牛  刘炯  梁宏伟
作者单位:山西医科大学第二医院核医学科, 山西 太原 030001;山西医科大学第二医院核医学科, 山西 太原 030001;山西医科大学第二医院核医学科, 山西 太原 030001;山西医科大学第二医院核医学科, 山西 太原 030001;山西医科大学第二医院核医学科, 山西 太原 030001
摘    要:目的 探讨99Tcm-羟基亚甲基二磷酸盐(99Tcm-MDP)骨显像诊断类风湿关节炎(RA)骨痛的价值。方法 回顾性分析40例确诊RA患者,均接受99Tcm-MDP骨显像,同期测定血清类风湿因子(RF)、抗环瓜氨酸肽抗体(anti-CCP)、抗突变型瓜氨酸波形蛋白抗体(anti-MCV)、葡萄糖-6-磷酸异构酶(GPI)、血沉(ESR)、C-反应蛋白(CRP)及免疫球蛋白G(LgG)。通过勾画ROI技术测出代谢最活跃关节的最高计数(Maxcount),以其作为因变量,采用线性逐步回归分析Maxcoun与RF、anti-CCP、anti-MCV、GPI、ESR、CRP、LgG的相关性。结果 anti-MCV对Maxcount具有显著性影响(Beta=0.414,P=0.008),且呈正相关(B=0.031,P=0.008),回归方程有统计学意义(F=7.862,P=0.008);其余6项血清测定值与Maxcount无明显相关(P均>0.05)。Pearson积距相关系数单侧检验显示anti-MCV与anti-CCP、ESR与CRP均显著正相关,且关系较密切 (r均>0.50,P均<0.001)。结论 99Tcm-MDP骨显像不仅可早期诊断RA患者软骨和(或)骨破坏,还可间接提示RA是否处于活动期。

关 键 词:体层摄影术  发射型计算机  单光子  骨显像  关节炎  类风湿  骨关节炎
收稿时间:2013/12/13 0:00:00
修稿时间:2014/5/10 0:00:00

Application of 99Tcm-MDP bone scan in rheumatoid arthritis with bone erosion
GAO Hai-yan,ZHAO De-shan,ZHANG Bao-niu,LIU Jiong and LIANG Hong-wei.Application of 99Tcm-MDP bone scan in rheumatoid arthritis with bone erosion[J].Chinese Journal of Medical Imaging Technology,2014,30(7):1058-1062.
Authors:GAO Hai-yan  ZHAO De-shan  ZHANG Bao-niu  LIU Jiong and LIANG Hong-wei
Institution:Department of Nuclear Medicine, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China;Department of Nuclear Medicine, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China;Department of Nuclear Medicine, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China;Department of Nuclear Medicine, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China;Department of Nuclear Medicine, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China
Abstract:Objective To explore the value of 99Tcm-MDP bone scanning in diagnosis of rheumatoid arthritis (RA) with bone pain. Methods A total of 40 RA patients who underwent 99Tcm-MDP bone scanning were retrospectively analyzed, and a series of serum assay, such as rheumatoid factors (RF), anti-cyclic citrullinated peptide (anti-CCP), anti-mutated citrullinated vimentin (anti-MCV), glucose-6-phosphat isome-ras (GPI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and immuno-globulin G (IgG) were obtained and compared in the same period. The dependent variable maximum count (Maxcount) of joint with the highest metabolism were acquired by drawing ROI methods, and the correlation among Maxcount and RF, anti-CCP, anti-MCV, GPI, ESR, CRP, LgG were analyzed respectively with linear stepwise regression. Results anti-MCV had significant effect to Maxcount (Beta=0.414, P=0.008). There was positive correlation between anti-MCV and Maxcount (B=0.031, P=0.008), and the stepwise regression equation was statistically significant (F=7.862, P<0.01). However, there was no significant correlation among Maxcount and the remaining six serum assay (all P>0.05). Pearson correlation matrix showed significantly relatively strong positive relationship between anti-MCV and anti-CCP, ESR and CRP, respectively (both r>0.50, P<0.001). Conclusion 99Tcm-MDP bone scanning can not only be used for early diagnosis of bone erosion, but also for indirect prompt of RA activity.
Keywords:Tomography  emission-computed  single-photon  Bone scan  Arthritis  rheumatoid  Osteoarthritis
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