99m锝焦磷酸盐骨闪烁显像在透析性骨营养不良检查中的应用价值

Usefulness of 99mTc pyrophosphate bone scintigraphy in the survey of dialysis osteodystrophy.

作者信息

Vanherweghem J L, Schoutens A, Bergman P, Dhaene M, Goldman M, Fuss M, Kinnaert P

出版信息

Proc Eur Dial Transplant Assoc Eur Ren Assoc. 1985;21:431-4.

Abstract

Fogelman's score (FS) was used to determine the usefulness of 99mTc pyrophosphate (Tc-PP) bone scintigraphy in the evaluation of dialysis osteodystrophy. FS correlated well with bone 47Ca accretion rate. It remained stable after six months in patients treated with 1 alpha (OH)D3 and increased significantly in a randomised group of untreated patients. It decreased after two years of 1 alpha (OH)D3 therapy while serum calcium increased and iPTH and alkaline phosphatases decreased. Patients with low FS, treated by 1 alpha (OH)D3, rapidly developed hypercalcaemia. In cases of spontaneous hypercalcaemia, parathyroidectomy did not normalise serum calcium in patients with low FS despite a significant decrease in serum iPTH. Lower FS were associated with a higher increase in serum aluminium after desferrioxamine (DFO) administration and in two cases of proven aluminium osteomalacia, DFO therapy was followed by a dramatic increase in FS.

摘要

福格尔曼评分（FS）用于确定99m锝焦磷酸盐（Tc-PP）骨闪烁显像在评估透析性骨营养不良中的效用。FS与骨47钙积聚率密切相关。在接受1α（OH）D3治疗的患者中，六个月后该评分保持稳定，而在一组未经治疗的随机分组患者中则显著升高。在接受1α（OH）D3治疗两年后，该评分下降，而血清钙升高，甲状旁腺激素（iPTH）和碱性磷酸酶下降。接受1α（OH）D3治疗的低FS患者迅速出现高钙血症。在自发性高钙血症的病例中，尽管血清iPTH显著降低，但甲状旁腺切除术并未使低FS患者的血清钙恢复正常。较低的FS与去铁胺（DFO）给药后血清铝的较高升高相关，在两例经证实的铝性骨软化症病例中，DFO治疗后FS急剧升高。