白细胞锝 99m 摄取在克罗恩病中的应用：是否能显示亚临床疾病？
Leukocyte-technetium-99m uptake in Crohn's disease: does it show subclinical disease?
机构信息
Radioisotope Laboratory, Pharmacy Faculty, Federal University of Minas Gerais, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
出版信息
World J Gastroenterol. 2010 Jan 21;16(3):365-71. doi: 10.3748/wjg.v16.i3.365.
AIM
To evaluate inflammatory activity in patients with Crohn's disease (CD) using technetium-99m-hexamethylpropyleneamine oxime (99mTc-HMPAO) granulocyte scintigraphy.
METHODS
Twenty patients (7 male and 13 female) with CD and five healthy volunteers were selected for 99mTc-HMPAO granulocyte scintigraphy. The Crohn's Disease Activity Index (CDAI), blood tests and C-reactive protein (CRP) of each patient were performed 7 d before the scintigraphic images. The leukocytes were labeled according to the International Society of Radiolabeled Blood Elements (ISORBE) consensus protocol and the scintigraphic images, including single photon emission computed tomography, were obtained 30 min and 2 h after injection of the radiolabeled leukocytes.
RESULTS
The labeling yield of the leukocytes with the lipophilic complex 99mTc-HMPAO was 55.0% +/- 10%. Six of the 20 patients (30%) presented congruent results for the three parameters investigated (CDAI, Scintigraphic Index and CRP). On the other hand, 14 patients (70%) did not show congruent results. There was no significant correlation between the indices analyzed according to the Spearman test (P > 0.05, n = 20).
CONCLUSION
The results suggest that 99mTc-HMPAO-labeled leukocyte scintigraphy could be important for determining inflammatory activity in CD even in the absence of clinical symptoms.
目的
用 99mTc-六甲基丙烯酰胺肟（99mTc-HMPAO）白细胞闪烁显像评价克罗恩病（CD）患者的炎症活动度。
方法
选择 20 例 CD 患者（男 7 例，女 13 例）和 5 名健康志愿者进行 99mTc-HMPAO 白细胞闪烁显像。每位患者均在显像前 7 天进行克罗恩病活动指数（CDAI）、血液检查和 C 反应蛋白（CRP）检查。根据国际放射性标记血元素学会（ISORBE）共识方案对白细胞进行标记，在注入放射性标记白细胞后 30min 和 2h 进行单光子发射计算机断层扫描（SPECT）获得闪烁显像图像。
结果
亲脂性复合物 99mTc-HMPAO 标记白细胞的标记产率为 55.0%±10%。20 例患者中，有 6 例（30%）3 项参数（CDAI、显像指数和 CRP）检查结果一致。另一方面，有 14 例（70%）患者检查结果不一致。Spearman 检验分析各指数之间无显著相关性（P＞0.05，n=20）。
结论
结果表明，即使在没有临床症状的情况下，99mTc-HMPAO 标记白细胞闪烁显像也可用于确定 CD 的炎症活动度。
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