Okudan Berna, Sahin Mehmet, Ozbek Feride Meltem, Keskin Ali Umit, Cüre Erkan
Nuclear Medicine Department, Suleyman Demirel University, School of Medicine, Isparta, Turkey.
Ann Nucl Med. 2005 Sep;19(6):455-60. doi: 10.1007/BF02985572.
Rheumatoid arthritis (RA) is a systemic autoimmune disorder primarily involving the joints. Lung alterations in RA may be primary or secondary to pharmacological treatments and may involve the alveoli, interstitium, airways and/or pleura. Technetium-99m diethylenetriaminepentaacetic acid (Tc-99m DTPA) aerosol inhalation scintigraphy is a sensitive and noninvasive test commonly employed to assess pulmonary epithelial membrane permeability. The purpose of the this study was a) to investigate the changes of pulmonary alveolar epithelial permeability in patients with RA, b) to determine the relationship between the clearance rate of Tc-99m DTPA and pulmonary function test (PFT) results, and c) to determine the relationship between the clearance rete of Tc-99m DTPA and clinical parameters of disease. Twenty-five patients with RA but without lung alterations were included in the study. The patients were 22 females, and 3 males; mean age 53.6 +/- 8.7 years. Technetium-99m DTPA aerosol inhalation scintigraphy was performed on the study and healthy control groups. Clearance half times (T1/2) were calculated by placing a mono-exponential fit on the curves. Penetration index (PI) was calculated on the first-minute image. There were no significant differences in the mean T1/2 or mean PI values between the RA patients and control subjects. No correlation was found between the mean T1/2 values of Tc-99m DTPA clearance and activity of RA, clinical values, or the spirometric measurements except FEV1/FVC and functional status in RA patients (p = 0.02, p = 0.01, respectively). However, a weak correlation was found between duration of disease and T1/2 values of Tc-99m DTPA clearance (p = 0.006). PI values tended to correlate with FEF25-75, although, this was not statistically significant (p = 0.057). This study shows that no changes occur in alveolar-capillary permeability in RA patients without lung alterations.
类风湿关节炎（RA）是一种主要累及关节的全身性自身免疫性疾病。RA患者的肺部改变可能是原发性的，也可能继发于药物治疗，可累及肺泡、间质、气道和/或胸膜。锝-99m二乙三胺五乙酸（Tc-99m DTPA）气溶胶吸入闪烁扫描是一种常用的敏感且无创的检查，用于评估肺上皮细胞膜通透性。本研究的目的是：a）调查RA患者肺泡上皮通透性的变化；b）确定Tc-99m DTPA清除率与肺功能测试（PFT）结果之间的关系；c）确定Tc-99m DTPA清除率与疾病临床参数之间的关系。本研究纳入了25例无肺部改变的RA患者。患者中女性22例，男性3例；平均年龄53.6±8.7岁。对研究组和健康对照组进行了Tc-99m DTPA气溶胶吸入闪烁扫描。通过对曲线进行单指数拟合计算清除半衰期（T1/2）。在第1分钟图像上计算穿透指数（PI）。RA患者与对照组之间的平均T1/2或平均PI值无显著差异。除了RA患者的FEV1/FVC和功能状态外，未发现Tc-99m DTPA清除的平均T1/2值与RA活动度、临床值或肺量计测量值之间存在相关性（分别为p = 0.02，p = 0.01）。然而，发现病程与Tc-99m DTPA清除的T1/2值之间存在弱相关性（p = 0.006）。PI值倾向于与FEF25-75相关，尽管这在统计学上不显著（p = 0.057）。本研究表明，无肺部改变的RA患者的肺泡-毛细血管通透性无变化。
