Graves眼病患者生长抑素受体闪烁显像的应用价值  

Applied value of somatostatin receptor scintigraphy in patients with Graves' ophthalmopathy

作　　者：赵荣[1] 汪静[1] 邓敬兰[1] 梁晓燕[1] 曾瑾[1] 王江[2] 

机构地区：[1]第四军医大学西京医院核医学科,中国陕西省西安市710032 [2]第四军医大学西京医院肝胆外科,中国陕西省西安市710032

出　　处：《国际眼科杂志》2007年第1期92-94,共3页International Eye Science

基　　金：中国国家自然科学基金资助项目(No.30570526;30270414);全军医药卫生科研基金资助项目(No.01MB120)~~

摘　　要：目的:探讨99mTc-OCT生长抑素受体显像在活动期Graves眼病(GO)免疫治疗中的价值。方法:采用直接法标记制备99mTc-OCT,纸层析法测定标记率。GO患者15例,健康志愿者4例为正常对照组。注射99mTc-OCT740MBq,4h后进行头部SPECT+CT断层和左、右侧位平面显像,次日所有患者给予强的松(30mg/d,分3次服用,疗程为1mo)治疗后再次行99mTc-OCT显像。测定2次显像眼眶(O)与枕部(OC)的感兴趣区(ROI)放射性计数及计算双侧眼眶(O)/枕叶(OC)放射性比值。计算GO患者治疗前、后的眼病指数(OI),进行其临床活动度的评价。结果:活动期GO患者12例治疗前O/OC比值为(1.64±0.13),显著高于正常对照(1.16±0.04)及治疗后(1.21±0.09)(P<0.05);其治疗后O/OC比值及两者与对照组比较无显著性差别(P>0.05)。非活动期GO患者3例治疗前、后O/OC比值与对照组比较差别无显著性(P>0.05)。结论:活动期GO患者眼眶明显摄取99mTc-OCT,表明99mTc-OCT显像可作为GO患者选择激素治疗及评价疗效的客观而可靠的指标。AIM： To investigate the evaluation of orbital somatostatin receptor scintigraphy with 99mTc-OCT in patients with activity Graves＇ ophthalmopathy＇s response to corticosteroid therapy. METHODS： OCT, a somatostatin analog, was labeled with 99mTc by a direct method. The compound＇s labeling efficiency was confirmed by paper chromatography. There were 15 patients with Graves＇ ophthaimopathy （GO） and 4 volunteers （control group, CG） without eye disease or GO in the study. Single photon emission computed tomography （SPECT）, computed tomography （CT） and left/right lateral position planar imaging of the head were obtained 4 hours after the i.v. injection of 740MBq of 99mTc-OCT, corticosterold therapy （methylprednisolone,10mg qo t i d. for 1 month） was given for all patients at the next day. In all patient SRS was performed again after 1 month. Radioligand uptake within each orbit （O） and occipital （OC） was measured using the region of interests （ROI） method and the O-to-OC ratio was determined before and after corticosteroid treatment. Clinical activity of GO was evaluated before and after treatment by calculating the ophthalmopathy index （OI）. RESULTS： A significant change of O/OC ratio was observed between pre- and post-treatment in 12 patients with active GO （1.64±0.13 vs 1.21 ±0.09, P〈0.05）, and in those CG （1.16±0.04, P 〈0.05） at the scintigraphy. No significant change of O/OC ratio was observed between CGand posttreat ment GO （1.16±0.04 vs 1.21±0.09, P〉0.05） nor of O/OC ratio was observed in the 3 patients with inactive GO （P 〉0.05） both pretreatment and post-treatment, and in those CG （P 〉0.05）. CONCLUSION： In patient with active GO, SRS showed markedly increased orbital uptake of 99mTc-OCT. The study demonstrated that 99mTc-OCT sdntigraphy can predict the clinical response to corticosteroid therapy in patient with GO, and may be considered an objective and safety approach to select the patient for the proper treatment.

关 键 词：G-raves眼病 生长抑素受体 单光子发射型计算机断层显像(SPECT) ^99M锝 奥曲肽 

分 类 号：R771.3[医药卫生—眼科]