Tiepolt C, Grüning T, Franke W-G
Department of Nuclear Medicine, Carl Gustav Carus Medical School, University of Technology, Fetscherstrasse 74, 01307 Dresden, Germany.
Nucl Med Commun. 2002 Jan;23(1):61-6. doi: 10.1097/00006231-200201000-00010.
Radium (224Ra) is commercially available again for the treatment of ankylosing spondylitis. Twenty patients suffering from ankylosing spondylitis were treated with weekly intravenous (i.v.) injections of 1 MBq 224Ra for 10 weeks. Therapeutic effect was measured by C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and full blood count, as well as a completion of the Bath ankylosing spondylitis functional index (BASFI) questionnaire. Follow-up was done after three and six months. At the end of the treatment course pain and movement restrictions had improved subjectively in 12 out of 20 patients. These patients were also able to discontinue or reduce their analgesic or anti-inflammatory medications. Subjective improvement was well correlated with a reduction of CRP by 45% and BASFI by 73%. At the six-month follow-up, ten patients reported a lasting improvement, whereas two had suffered a relapse. A late therapeutic response after three months was seen in a single patient only. Patients who did not respond to radium had lower initial levels of acute-phase reactants and peripheral joint involvement. Only mild side-effects, e.g. temporary worsening of pain, were observed. Leukocytes and platelets reversibly decreased by 25%, respectively. It is concluded that 224Ra is an effective and safe treatment for ankylosing spondylitis.
镭（224Ra）再次可用于商业治疗强直性脊柱炎。20例强直性脊柱炎患者接受每周一次静脉注射1 MBq 224Ra，共10周。通过C反应蛋白（CRP）、红细胞沉降率（ESR）和全血细胞计数以及完成巴斯强直性脊柱炎功能指数（BASFI）问卷来衡量治疗效果。在三个月和六个月后进行随访。在治疗疗程结束时，20例患者中有12例的疼痛和活动受限在主观上有所改善。这些患者还能够停用或减少他们的止痛或抗炎药物。主观改善与CRP降低45%和BASFI降低73%密切相关。在六个月的随访中，10例患者报告有持续改善，而2例复发。仅1例患者在三个月后出现延迟治疗反应。对镭无反应的患者急性期反应物初始水平较低且有外周关节受累。仅观察到轻微的副作用，例如疼痛暂时加重。白细胞和血小板分别可逆性降低25%。结论是224Ra是治疗强直性脊柱炎的一种有效且安全的方法。
