Cabuk Mehmet, Ozdolap Senay, Altin Remzi, Kart Levent, Peksoy Irfan, Sarikaya Selda, Aksoy Nilgun Balkan, Besir Halit Fahri, Mahmutyazicioglu Kamran
Department of Nuclear Medicine, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey.
Hell J Nucl Med. 2009 Jan-Apr;12(1):17-21.
The association of ankylosing spondylitis (AS) and lung parenchyma abnormalities has been shown in previous studies by radiological and pulmonary function tests. Technetium-99m diethylene triamine pentaacetic acid ((99m)Tc-DTPA) dynamic lung scanning is an easy, noninvasive method to assess alveolar-capillary barrier permeability. We aimed to study the abnormalities in pulmonary clearance of (99m)Tc-DTPA in patients with AS, and the presence of any correlation between this clearance and the radiological and pulmonary function tests. We studied twenty-one nonsmoker patients with AS who were compared to 21 age and sex matched healthy volunteers. All subjects underwent pulmonary function tests and pulmonary scintigraphy with (99m)Tc-DTPA to evaluate pulmonary clearance. Clearance half time (T(1/2)) of (99m)Tc-DTPA through the lungs was calculated by placing a monoexponential fit on the 30 min activity curves. High resolution CT and pulmonary function tests were performed for each patient. Our results showed the following: Spirometric parameters of forced vital capecity (FVC) and theratio of forced expiratory value in 1sec/FVC (FEV1%) scores were worse in patients compared to the control group (P<0.005 and P<0.05, respectively). Clearance half time was longer in AS group than in the control group (58.45+/-7.59 and 51.62+/-4.79 min, respectively; P<0.05). There was a negative correlation between T(1/2) value and FEV1% (r=-0.876, P< 0.01), of AS patients and the control group. Additionally, there were moderate positive correlation between T(1/2) and FVC (r=0.705, P<0.001), weak positive correlation between T(1/2) and FEF2575 (r=0.493, P<0.05), and T(1/2) and DLCO (r=0.444, P<0.05). A positive correlation was found between the duration of the disease and T(1/2) (r=0.44, P<0.05). In conclusion, longer T(1/2) values and lower FVC values in nonsmoker AS patients may suggest not only the pulmonary involvement in AS but also the duration of the disease.
既往研究通过影像学检查和肺功能测试已证实强直性脊柱炎（AS）与肺实质异常之间存在关联。锝-99m二乙三胺五乙酸（（99m）Tc-DTPA）动态肺扫描是一种评估肺泡-毛细血管屏障通透性的简便、无创方法。我们旨在研究AS患者中（99m）Tc-DTPA肺清除的异常情况，以及这种清除与影像学检查和肺功能测试之间是否存在相关性。我们研究了21例不吸烟的AS患者，并与21例年龄和性别匹配的健康志愿者进行比较。所有受试者均接受肺功能测试和用（99m）Tc-DTPA进行肺闪烁扫描以评估肺清除情况。通过对30分钟活性曲线进行单指数拟合来计算（99m）Tc-DTPA通过肺部的清除半衰期（T（1/2））。对每位患者进行高分辨率CT和肺功能测试。我们的结果如下：与对照组相比，患者的用力肺活量（FVC）和1秒用力呼气量/FVC（FEV1%）评分的肺量计参数更差（分别为P<0.005和P<0.05）。AS组的清除半衰期比对照组更长（分别为58.45±7.59分钟和51.62±4.79分钟；P<0.05）。AS患者和对照组的T（1/2）值与FEV1%之间存在负相关（r=-0.876，P<0.01）。此外，T（1/2）与FVC之间存在中度正相关（r=0.705，P<0.001），T（1/2）与FEF2575之间存在弱正相关（r=0.493，P<0.05），T（1/2）与DLCO之间存在弱正相关（r=0.444，P<0.05）。疾病持续时间与T（1/2）之间存在正相关（r=0.44，P<0.05）。总之，不吸烟的AS患者较长的T（1/2）值和较低的FVC值可能不仅提示AS存在肺部受累，还提示疾病持续时间。
