Oyen Wim J G, Arntz Ivo E, Claessens Roland A M J, Van der Meer Jos W M, Corstens Frans H M, Goris Jan A R
Department of Nuclear Medicine, University Hospital Nijmegen, NijmegenNetherlands Department of Surgery, University Hospital Nijmegen, NijmegenNetherlands Department of Internal Medicine, University Hospital Nijmegen, NijmegenNetherlands.
Pain. 1993 Nov;55(2):151-157. doi: 10.1016/0304-3959(93)90144-E.
In 23 patients with reflex sympathetic dystrophy (RSD) of the hand, scintigraphy with indium-111 labeled human non-specific polyclonal immunoglobulin G (In-111-IgG) was performed to investigate whether inflammatory characteristics are present in RSD. Both blood flow and accumulation over 48 h were assessed. Nineteen patients had increased flow to the affected hand, and 3 had decreased flow. One patient had bilateral RSD. Exercise provoked aggravation of complaints and signs in all patients. The affected/non-affected hand ratio (target-to-background, T/B) immediately before and after exercise did not change significantly. The T/B ratios 48 h after In-111-IgG injection were significantly higher in patients with RSD less than 5 months than in patients with RSD existing 5 months or longer. The T/B ratios 24 and 48 h after In-111-IgG injection were not correlated with the flow T/B ratios. In fact, 2 of the 3 patients with a decreased flow showed excess accumulation on the late images. Significantly more patients with early RSD, existing less than 5 months, had a positive In-111-IgG scintigraphy (14 of 17) than the patients with late RSD (1 of 6). Increased vascular permeability for macromolecules, an important characteristic of inflammation, appears to play a role in the development of RSD. This phenomenon is not flow-dependent.
对23例手部反射性交感神经营养不良（RSD）患者进行了铟-111标记的人非特异性多克隆免疫球蛋白G（In-111-IgG）闪烁扫描，以研究RSD是否存在炎症特征。评估了48小时内的血流和聚集情况。19例患者患侧手部血流增加，3例血流减少。1例患者为双侧RSD。运动使所有患者的症状和体征加重。运动前后患侧/非患侧手部比值（靶本底比值，T/B）无明显变化。In-111-IgG注射后48小时，病程小于5个月的RSD患者的T/B比值显著高于病程5个月及以上的患者。In-111-IgG注射后24小时和48小时的T/B比值与血流T/B比值无关。事实上，3例血流减少的患者中有2例在延迟图像上显示有过量聚集。病程小于5个月的早期RSD患者In-111-IgG闪烁扫描阳性（17例中的14例）的比例显著高于晚期RSD患者（6例中的1例）。大分子血管通透性增加作为炎症的一个重要特征，似乎在RSD的发生发展中起作用。这种现象不依赖于血流。
