Royston D, Braude S, Nolop K B
Department of Anaesthesia, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Thorax. 1987 Jul;42(7):494-9. doi: 10.1136/thx.42.7.494.
The rate of clearance of technetium-99m labelled diethylene triamine pentacetic acid (99mTc DTPA) was measured in 32 patients with adult respiratory distress syndrome to determine if a more rapid clearance rate, possibly reflecting a more severe abnormality of pulmonary function, was associated with a reduced likelihood of recovery from pulmonary failure. Although the mean rate of clearance from lung to blood (T1/2LB) of 99mTc DTPA was more rapid in the patients (T1/2LB = 29 (SEM 3.2) min than in 42 normal subjects (T1/2LB = 59 (1.8)min), there was no difference between the clearance rate in the 18 patients who recovered from respiratory failure (T1/2LB = 31 (5) min) and the 14 who died (T1/2LB = 27 (4) min). Additionally, not all patients studied had abnormally rapid clearance rates. In 12 of the 32 patients the T1/2 fell within the range for normal individuals; this was found more commonly in patients who were predisposed to develop adult respiratory distress syndrome by pancreatitis or massive blood transfusion. These data suggest that a single measurement of 99mTc DTPA clearance in patients with established respiratory failure and adult respiratory distress syndrome is of no value in assessing the likelihood of recovery from this condition.
对32例成人呼吸窘迫综合征患者测定了锝-99m标记的二乙三胺五乙酸（99mTc DTPA）的清除率，以确定更快速的清除率（可能反映更严重的肺功能异常）是否与肺衰竭恢复可能性降低相关。尽管患者中99mTc DTPA从肺到血液的平均清除率（T1/2LB）（T1/2LB = 29（标准误3.2）分钟）比42名正常受试者（T1/2LB = 59（1.8）分钟）更快，但从呼吸衰竭中恢复的18例患者（T1/2LB = 31（5）分钟）与死亡的14例患者（T1/2LB = 27（4）分钟）的清除率并无差异。此外，并非所有研究患者的清除率都异常快速。在32例患者中的12例中，T1/2处于正常个体范围内；这在因胰腺炎或大量输血而易患成人呼吸窘迫综合征的患者中更为常见。这些数据表明，对已确诊呼吸衰竭和成人呼吸窘迫综合征的患者单次测量99mTc DTPA清除率对评估从该病症中恢复的可能性没有价值。
