甲状旁腺激素在尿毒症透析患者甲状旁腺SPECT/CT显像中的价值  

The Value of Parathyroid Hormone Serum Levels in Uremic Hemodialysis Patientswith Parathyroid ^(99)Tc^m-MIBI SPECT / CT Imaging

作　　者：樊孝廉 黄胜 鲁胜男 肖玉根 古炎发 张爱芳 

机构地区：[1]佛山市南海区人民医院,广东佛山528200

出　　处：《标记免疫分析与临床》2015年第5期439-441,共3页Labeled Immunoassays and Clinical Medicine

基　　金：广东省佛山市卫生局科研立项;项目编号:2013年度228号

摘　　要：目的探讨甲状旁腺激素测定对尿毒症透析患者甲状旁腺SPECT/CT显像的临床价值。方法对63例尿毒症长期透析患者在透析前行甲状旁腺激素测定,99Tcm-MIBI早期及延迟甲状旁腺平面显像,并在延迟显像时行SPECT断层显像及同机CT扫描并进行图像融合,分析甲状旁腺激素水平与甲状旁腺显像及同机CT扫描间的关系。结果早期平面显像显示甲状腺影像,延迟平面显像阳性率61.90%(39/63);断层显像及图像融合66.67%(42/63)。42例显像阳性患者PTH均值为(1509.91±614.25)ng/m L,其中19例显像阳性接受手术患者PTH均值为(1423.37±520.49)ng/m L,其余23例PTH结果为(1538.61±572.93)ng/m L,二者比较差异无统计学意义(P>0.05);21例显像阴性患者PTH均值为(944.21±721.43)ng/m L,与显像阳性患者的PTH值比较,差异具有统计学意义(P<0.01)。结论根据长期透析尿毒症患者的PTH水平,有选择的行99Tcm-MIBI甲状旁腺SPECT/CT融合显像,能更有针对性的发现病灶并对病灶进行定位,较常规平面和断层显像有更高的诊断价值。Objective To investigate the clinical application value of parathyroid hormone levels in uremic hemodialysis patients with parathyroid 99Tcm -MIBI SPECT/CT fusion imaging. Methods The serum parathyroid hormone levels in 63 urenmic patients before hemodialysis were measured, and then all patients accepted parathyroid 99Tcm -MIBI SPECT/CT planar imaging at 10 rain and 120 min post-injection, additional tomography and CT scan fusion imaging at 120 rain post-injection. The relevance between the parathyroid hormone serum levels and SPECT/ CT imaging results was analyzed. Results The early planar imaging showed the thyroid images, and the delay planar imaging showed a positive rate of 61.90% （39/）63）. The positive rate of tomography and fusion imaging was 66.67% （42/63）. The mean levels of serum parathyroid hormone （PTH） in 42 parathyroid imaging positive patients were 1509.91 ± 614. 25 ng/mL. The mean levels of serum parathyroid hormone in 19 patients confirmed by surgery operation and the other 23 patients were 1423.37±520.49 ng/mL and 1538.61 ±572.93 ng/mL respectively. There was no statistically significant difference between them （ P 〉 0.05 ）. The mean serum PTH levels in 21 negative imaging patients was 944.21 ± 721.43 ng/mL, there was a statistically significant difference compared with the 42 positive imaging patients （P 〈 0. 01 ）. Conclusion The suspicious uremic hemodialysis patient based on the parathyroid hormone serum levels adapted to parathyroid 99Tcm-MIBI SPECT/CT could improve the examination positive rate and locate the lesions for surgery. The 99Tcm- MIBI SPECT/CT fusion imaging has more diagnostic value compared with the route planar and t,＇mography imaging.

关 键 词：99Tcm-甲氧异腈 甲状旁腺激素 尿毒症 单光发射型计算机断层扫描仪 

分 类 号：R692.5[医药卫生—泌尿科学] R817.4[医药卫生—外科学]