【摘要】 目的探讨99 Tcm-羟基亚甲基二磷酸盐(99 Tcm-MDP)骨显像诊断类风湿关节炎(RA)骨痛的价值。方法回顾性分析40例确诊RA患者,均接受99 Tcm-MDP骨显像,同期测定血清类风湿因子(RF)、抗环瓜氨酸肽抗体(antiCCP)、抗突变型瓜氨酸波形蛋白抗体(anti-MCV)、葡萄糖-6-磷酸异构酶(GPI)、血沉(ESR)、C-反应蛋白(CRP)及免疫球蛋白G(LgG)。通过勾画ROI技术测出代谢最活跃关节的最高计数(Maxcount),以其作为因变量,采用线性逐步回归分析Maxcoun与RF、anti-CCP、anti-MCV、GPI、ESR、CRP、LgG的相关性。结果 anti-MCV对Maxcount具有显著性影响(Beta=0.414,P=0.008),且呈正相关(B=0.031,P=0.008),回归方程有统计学意义(F=7.862,P=0.008);其余6项血清测定值与Maxcount无明显相关(P均>0.05)。Pearson积距相关系数单侧检验显示anti-MCV与anti-CCP、ESR与CRP均显著正相关,且关系较密切(r均>0.50,P均<0.001)。结论 99 Tcm-MDP骨显像不仅可早期诊断RA患者软骨和(或)骨破坏,还可间接提示RA是否处于活动期。更多还原

【Abstract】 Objective To explore the value of 99 Tcm-MDP bone scanning in diagnosis of rheumatoid arthritis(RA)with bone pain.Methods A total of 40RA patients who underwent 99 Tcm-MDP bone scanning were retrospectively analyzed,and a series of serum assay,such as rheumatoid factors(RF),anti-cyclic citrullinated peptide(anti-CCP),anti-mutated citrullinated vimentin(anti-MCV),glucose-6-phosphat isome-ras(GPI),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and immuno-globulin G(IgG)were obtained and compared in the same period.The dependent variable maximum count(Maxcount)of joint with the highest metabolism were acquired by drawing ROI methods,and the correlation among Maxcount and RF,anti-CCP,anti-MCV,GPI,ESR,CRP,LgG were analyzed respectively with linear stepwise regression.Results anti-MCV had significant effect to Maxcount(Beta=0.414,P=0.008).There was positive correlation between anti-MCV and Maxcount(B=0.031,P=0.008),and the stepwise regression equation was statistically significant(F=7.862,P<0.01).However,there was no significant correlation among Maxcount and the remaining six serum assay(all P>0.05).Pearson correlation matrix showed significantly relatively strong positive relationship between anti-MCV and anti-CCP,ESR and CRP,respectively(both r>0.50,P<0.001).Conclusion 99 Tcm-MDP bone scanning can not only be used for early diagnosis of bone erosion,but also for indirect prompt of RA activity.更多还原