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目的 客观评价原发性干燥综合征 (pSS)患者的唾液腺功能 ,筛选敏感、有意义的99mTcO-4 唾液腺显像功能参数。方法 78例 pSS和 2 0例为甲状腺结节患者为对照分别进行了99TcmO-4 唾液腺动态显像 ,所有 pSS患者于显像后进行唇腺活检 ,对显像所得功能参数与唇腺活检的病理分级进行等级相关性分析 ,对显像特点和病理关系进行了总结。结果 ①腮腺 (Par)对99mTcO-4 浓聚率 (MAR)随病理分级增大而降低 (r =- 0 6 49,P <0 0 0 1) ;酸刺激开始至刺激后放射性降低不变的时间间隔 (Tmin)随病理分级增加而延长 (r =0 32 4,P <0 0 1) ;Par的酸刺激最大分泌率 (MSR)随病理分级增加而减少 (r =- 0 5 2 1,P <0 0 0 1)。②早期分泌率 (SR)虽与病理分级无有意义的相关性 ,但在pSS早期 (病理 1~ 2级 )即可出现异常。③影像所示唾液腺功能受损程度与唇腺活检病理学改变和分级基本符合 ,总符合率为 80 8% (6 3/78)。结论 Par对99mTcO-4 的MAR降低、Tmin的延长、MSR的减少是pSS有意义的诊断指标 ,SR是 pSS非常敏感的筛检指标。99mTcO-4唾液腺显像是评价 pSS者唾液腺功能简便、无创的实用方法
Objective To objectively evaluate salivary gland function in patients with primary Sjogren’s Syndrome (pSS) and to screen sensitive and meaningful functional parameters of 99mTcO-4 salivary gland imaging. Methods 78 cases of pSS and 20 cases of thyroid nodules were used as controls for 99TcmO-4 salivary gland dynamic imaging. All pSS patients underwent labial gland biopsy after imaging. The imaging parameters and the pathology of labial gland biopsy Hierarchical grade correlation analysis, the imaging features and pathology were summarized. Results (1) Par (99mTcO-4) concentration decreased with the increase of pathological grade (r = - 0 6 49, P 0 01). The radioactive decrease of the 99mTcO- The time interval (Tmin) was prolonged with pathological grade (r = 0 32 4, P 0 01). The peak acid secretion rate (MSR) of Par decreased with pathological grade (r = - 0 521, P <0 0 0 1). ② early secretion rate (SR) Although no significant correlation with the pathological grade, but in the early pSS (pathological grade 1 to 2) can be abnormal. (3) The degree of salivary gland function impaired in the imaging basically accords with the pathological changes and grading of labial gland biopsy, the total coincidence rate was 80.8% (6 3/78). Conclusions The decrease of MAR, the extension of Tmin and the decrease of MSR in par with99mTcO-4are a meaningful diagnostic marker for pSS. SR is a very sensitive screening index for pSS. 99mTcO-4 salivary gland imaging is a practical and noninvasive method to evaluate the salivary gland function of pSS