【摘要】 目的探讨99Tcm-六甲基丙二胺肟(HMPAO)肺显像早期诊断博莱霉素所致肺损伤的临床价值及损伤肺异常摄取99Tcm-HMPAO的机制。方法24只兔随机分成Ⅰ、Ⅱ、Ⅲ、Ⅳ四组,Ⅰ组为空白对照组,正常饮食,Ⅱ、Ⅲ、Ⅳ组隔天分别经耳缘静脉给予0.2mg/kg0、.3mg/kg及0.5mg/kg的博莱霉素。服药前及服药8、16、243、2d后均行99Tcm-HMPAOSPECT显像,勾画右肺感兴趣区,计算注入99Tcm-HMPAO后60s(A60)和最高峰(Apeak)的活性比A60/Apeak,并绘制时间活度曲线。Ⅳ组给药16d后,Ⅰ、Ⅱ、Ⅲ组给药32d后将兔全部处死,取肺组织做光、电镜检查。结果Ⅱ、Ⅲ、Ⅳ给药组A60/Apeak值与对照组比较均有显著相差异(P<0.05)。光镜下肺组织呈轻微间质性肺炎改变,电镜下显示内皮细胞胞浆有水肿性改变,并可在胞浆内见大量吞银小泡。结论99Tcm-HMPAO肺显像能早期显示博莱霉素所致的肺损伤,肺毛细血管内皮细胞可能是99Tcm-HMPAO异常聚集的主要部位。更多还原

【Abstract】 Objective To investigate the lung uptake of ⁹⁹ Tc^m-hexamethyl propylene amine oxime（HMPAO） in the bleomycin-induced lung injury and the mechanism of its abnormal uptake. Methods 24 white rabbits were randomly divided into ,, and four groups. Group I （the control group） raised normally, and group , and was giving respectively 0.2 mg/kg,0.3 mg/kg and 0.5 mg/kg bleomycin by the ear range vein every other day. ⁹⁹ Tc^m-HMPAO prior static images were taken on baseline and 8,16,24,32 days after having bleomycin. ROIs were drawn on the right lung. A₆₀/A_peak were calculated and shown as s. Time-activity curve was drawn. 16 days after giving bleomycin in and 32 days in , and , all the rabbits were killed by cutting the lower limb artery. Lungs were taken out immediately to carry out light micrography and electrography detection. Results Compared with the control uptake of ⁹⁹ Tc^m-HMPAO , there was statistical difference in group , and 24,16,8 days after giving bleomycin respectively（P<0.05）. Light microscopy revealed typical interstitial pneumonia, but electronic microscopy showed edematous changes in the endothelial cytoplasm. A lot of pinocytotic vessicles were also seen in the cytoplasms.Conclusion ⁹⁹ Tc^m-HMPAO can be used to detect early lung injury in bleomycin-induced lung toxicity. Microvascular endothelium of lung is presumably the main location site of ⁹⁹ Tc^m-HMPAO abnormal concentration. [更多还原