Graves眼病眶部生长抑素受体显像研究  

Study of somatostatin receptor scintigraphy for Graves’ophthalmopathy

作　　者：李玲[1] 叶万忠[1] 李建[1] 陈侃[1] 张春华[1] 包建东[1] 

机构地区：[1]江苏省原子医学研究所江原医院内科,无锡214063

出　　处：《中华核医学杂志》2005年第3期166-167,i003,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的用99Tcm-奥曲肽(octreotide)SPECT眼眶显像评价Graves眼病活动度和预测免疫抑制疗效。方法Graves眼病患者39例,静脉注射925MBq99Tcmoctreotide后3h进行SPECT眼眶显像,利用感兴趣区技术,计算双侧眼眶(O)枕叶(OC)放射性比值。然后所有患者接受甲基强的松龙冲击治疗,计算治疗前和治疗1个月时的眼病指数(GOI)和临床活动度评分(CAS)。结果有效组34例,OOC比值为1.76±0.17;无效组5例,OOC比值为1.26±0.19(P<0.001)。OOC比值与治疗前CAS呈正相关(r=0.47,P<0.001),与治疗前后眼病指数差值(疗效)呈正相关(r=0.55,P<0.001)。OOC比值接受器工作特性(ROC)曲线下面积为0.971,当OOC比值取1.37时,阳性预测值为97%,阴性预测值为80%。结论OOC比值可反映Graves眼病患者眼病活动度和预测其免疫抑制疗效。Objective To investigate the clinical feasibility of orbital somatostatin receptor scintigraphy with 99Tcm-octreotide in evaluating clinical activity of Graves' ophthalmopathy and predicting the outcomes of immunosuppressive therapy. Methods 39 patients with Graves' ophthalmopathy were included and underwent SPECT imaging at 3 h after intravenous injection of 925 MBq 99Tcm-octreotide before one-month methylprednisolone treatment. 99Tcm-octreotide uptake defined as the ratio of orbital (O) and occipital (OC) uptake on fixed region of interest (ROI) (O/OC ratio) was calculated, the Graves' ophthalmic index (GOI) and clinical activity score (CAS) were also measured before and after treatment. Results The O/OC ratio was 1.76±0.17 for 34 responders, and 1.26±0.19 for 5 nonresponders, respectively(P<0.001),with a positive predictive value of 97% and a negative predictive value of 80%. There were positive correlations between pre-treated O/OC ratio and CAS (r=0.47,P<0.001), and post-treated GOI reduction (r=0.55,P<0.001). Conclusion O/OC ratio may serve as a disease activity parameter and a response predictor before immunosuppressive treatment.

关 键 词：GRAVES眼病 生长抑素受体 显像研究 ^99Tc^m-奥曲肽 甲基强的松龙冲击治疗 眶部 免疫抑制 眼病患者 SPECT 曲线下面积 阳性预测值 阴性预测值 活动度 静脉注射 感兴趣区 治疗前后 工作特性 正相关 OC 疗效 眼眶 性比值 

分 类 号：R581.1[医药卫生—内分泌] R737.9[医药卫生—内科学]