难治性贫血和慢性再生障碍性贫血患者的骨髓核素显像  

The Value of^(99m)Tc-Sodium Phytate Colloid Bone Marrow Scintigraphy in the Patients with Refractory Anemia and Chronic Aplastic Anemia

作　　者：曾波航[1] 刘泽霖[1] 蔡晓东[1] 邓力平[1] 庞缨[1] 冯莹[1] 

机构地区：[1]广州医学院第二附属医院,510260

出　　处：《中国误诊学杂志》2002年第5期657-659,共3页Chinese Journal of Misdiagnostics

摘　　要：目的　评价骨髓核素显像对难治性贫血 (RA)和慢性再生障碍性贫血 (CAA)的诊断、鉴别及疗效预测的作用。方法　 7例 RA和 2 0例 CAA患者注射显像剂 99m Tc-植酸钠后行前位和后位全身骨髓显像。结果　 7例 RA患者骨髓显像正常 ( 级 ) 4例 ,显像分布扩张 ( 级 ) 3例 ,无显像 级 (单纯显像不良 )和 级 (伴有灶性扩张的显像不良 )。 2 0例CAA患者骨髓显像 级和 级 15例 ,显像 级 5例 ,无显像 级。其中 5例 CAA患者首次骨髓细胞学检查曾诊断为RA,骨髓显像 4例为 级 (排除 RA) ,1例为 级 ,后经骨髓活检和多次骨髓细胞学检查确诊为 CAA。此外骨髓显像 级的 CAA患者治疗后有效率 (2 /9)明显低于显像 级和 级的 CAA患者 (9/11)。结论　骨髓核素显像可用于 RA和CAA鉴别诊断及预测Objective To evaluate bone marrow scintigraphy in diagnosis, differential diagnosis, judging prognosis in patients with refractory anemia (RA) and Chronic aplastic anemia (CAA).Methods 7 RA and 20 CAA patients were performed with Bone marrow scintigraphy using 99mTc- sodium phytate colloid 370～550 MBg.Results 4 normal marrow imagings (Grade Ⅲ) and 3 high activity and expanded periphery of bone marrows (Grade Ⅳ) were found and there were no marrow imagings showing uneven low accumulation (Grade Ⅰ) and focal pattern s (Grade Ⅱ) in RA group ,while 15 Grade Ⅰs ands and 5 Grade Ⅲs were found in CAA group. In CAA group,5 cases were first misdiagnosed as RA by bone marrow cytology check, but RA was excluded either when using bone marrow scintigraphy(Grade Ⅱ,4 cases) or subsequent bone marrow biopsies and cytology checks (Grade Ⅲ,1 case).In addition, the efficiency of CAA patients with Grade Ⅰ(2/11)was significantly lower than with either Grade Ⅱ or Grade Ⅲ (9/11) after treatment.Conclusions Bone marrow imaging was able to separate RA from CAA and predict treatment efficiency of CAA.

关 键 词：骨髓核素显像 难治性贫血 RA 慢性再生障碍性贫血 CAA 诊断 疗效 鉴别诊断 

分 类 号：R556.9[医药卫生—血液循环系统疾病] R556.5[医药卫生—内科学]