Bester M J, Van Heerden P D, Klopper J F, Wasserman H J, Rubow S, de Klerk F
Department of Nuclear Medicine, Tygerberg Hospital, South Africa.
Nucl Med Commun. 1995 Jul;16(7):599-607. doi: 10.1097/00006231-199507000-00012.
A considerable segment of the population of South Africa has a disease spectrum similar to those of the industrialized countries. However, a much larger proportion of its inhabitants comes from historically disadvantaged communities and is plagued by diseases typical of the developing world. Infectious diseases head the list as a cause of mortality in certain age groups. We have studied 108 patients presenting with a wide array of infections. Fifty-eight patients were examined with 67Ga-citrate and with 99Tcm-HMPAO-labelled leukocytes, 40 with leukocytes alone and 10 who had a high pre-test probability of tuberculosis with 67Ga only. The sensitivity and specificity of 99Tcm-labelled leukocyte scintigraphy in the 58 patients who had both studies were 89 and 84%, respectively, while the corresponding values for 67Ga scintigraphy were 81 and 74%, respectively. The overall sensitivity and specificity for 99Tcm-labelled leukocytes for detecting inflammatory sites in all 98 cases were 92 and 89%, respectively. Although labelled leukocytes were the better of the two agents for the early diagnosis of infections with a high probability of neutrophil infiltration, 67Ga remains an excellent alternative. It is the first choice in patients in whom tuberculosis or a neoplastic process is suspected as a cause of fever. It is also safer to use in areas where labelling of leukocytes is inadvisable because of inadequate sterility or where the risk is high of infecting other patients or staff with HIV.
南非相当一部分人口的疾病谱与工业化国家相似。然而，其居民中更大比例的人来自历史上处于不利地位的社区，饱受发展中世界典型疾病的困扰。在某些年龄组中，传染病是导致死亡的首要原因。我们研究了108例患有各种感染的患者。58例患者接受了枸橼酸镓-67和99锝-六甲基丙烯胺肟标记白细胞检查，40例仅接受白细胞检查，10例结核预测试验概率高的患者仅接受镓-67检查。在两项检查都做了的58例患者中，99锝标记白细胞闪烁扫描的敏感性和特异性分别为89%和84%，而镓-67闪烁扫描的相应值分别为81%和74%。在所有98例病例中，99锝标记白细胞检测炎症部位的总体敏感性和特异性分别为92%和89%。尽管在早期诊断有高概率中性粒细胞浸润的感染方面，标记白细胞是两种药物中较好的一种，但镓-67仍然是一种很好的替代药物。对于怀疑结核或肿瘤性病变是发热原因的患者，它是首选。在因无菌条件不足而不宜标记白细胞的地区，或感染其他患者或工作人员感染艾滋病毒风险高的地区，使用它也更安全。
