早期骨量减少的核医学诊疗实验研究  

Experimental study of nuclear medicine on the diagnosis and treatment of early bone loss

作　　者：叶智卫 蔡瑾[1] 梅小刚 朱吕佶 高克加 

机构地区：[1]上海市黄浦区中心医院核医学科,上海200002

出　　处：《中国骨质疏松杂志》2017年第3期328-332,387,共6页Chinese Journal of Osteoporosis

摘　　要：目的应用核素^(99)mTc-MDP骨骼显像评判早期骨量减少并早期干预治疗的实验研究。方法应用肌肉注射地塞米松磷酸钠针剂(DX)制作兔早期骨量减少模型和骨质疏松模型并采用^(99)Tc-MDP治疗,每周一次,共14w。经核素骨骼显像的感兴趣区部位与体外固定放射性标准源(RSF)的比值以及骨病理学、骨形态计量学、骨密度、骨生物力学、血清骨碱性磷酸酶(BALP)、骨钙素(BGP)、腰椎X、CT摄片等指标比较在各组间存在的差异,并对疗效作出评判。结果经注射不同剂量DX后对实验兔的早期骨量减少模型组和骨质疏松模型组进行骨组织病理切片,骨形态计量学、骨密度、骨生物力学、BALP、BGP等检测指标,证实动物模型成立。治疗14 w后,早期骨量减少治疗组在模型的基础上骨病理学显示:股骨头的骨小梁排列基本规则,骨小梁有所增粗;而骨质疏松治疗组骨病理则表现为骨小梁略有稀疏,骨小梁粗细不均匀,但无断裂现象。早期骨量减少模型、骨质疏松模型骨组织对核素99mTc-MDP骨骼显像剂摄取明显高于正常对照组(P<0.05),而治疗组较对应模型组有所下降(P<0.05)。早期骨量减少治疗组与正常组比较骨密度、骨形态计量指标变化不大(P>0.05),但是骨显像剂摄取明显高于正常组(P<0.05)。骨质疏松治疗组与正常组比较,骨密度、骨生物力学、BALP、BGP均有较明显的改善,以骨质疏松治疗组更明显(P<0.05)。结论核素^(99)mTc-MDP骨骼显像能够发现不同个体的早期骨质疏松现象,同时在早期骨量减少进行干预治疗的疗效将明显优于严重骨质疏松期。Objective To evaluate early bone loss by radionuclide ^（99）mTc-MDP bone imaging and to intervene in early stage.Methods Early bone loss and osteoporosis models were produce in rabbits by intramuscular injection of dexamethasone sodium phosphate（ DX） and then a treatment was used on the model rabbits.The treatment drug^（99）Tc-MDP was injected once a week,up to 14 weeks.The ratio between region of interest（ ROI） site of radionuclide bone imaging and the fixed radioactive standard source（ RSF）,bone histopathology,bone histomorphometry,bone mineral density,bone biomechanics,serum bone alkaline phosphatase（ BALP）,osteocalcin（ BGP）,and X ray and CT radiography of the lumbar vertebrae were determined,and the differences between the groups of were compared.Results After injection of different doses of DX on experimental rabbits,bone tissue pathological section,indexes of Bone morphological metrology,bone density,bone biomechanics,and BALP and BGP were used to confirm that the animal model was established successfully.After treatment for 14 weeks,early bone loss group showed that trabecular bone of the femoral head was arranged regularly and the trabecular bone was thickening comparing with those in the model group.However,the osteoporosis treatment group showed that trabecular bone was slightly sparse,and trabecular thickness was not uniform,but no fracture was found.The uptake of（99）mTc MDP bone scintigraphy agent in early bone loss model and osteoporosis bone tissue was significantly higher than that in control group（ P〈0.05）,but the uptake of imaging agent in the treatment group was significantly decreased than the corresponding model group（ P〈0.05）.Bone mineral density and bone histomorphometry were not significantly different between early bone loss treatment group and the control group（ P〉0.05）.But the uptake of imaging agent in the early bone loss treatment group was significantly higher than that in the normal control group（ P〈0.05）.Bone mineral density,bone

关 键 词：99MTC-MDP骨显像 早期骨量减少 骨质疏松 核医学 

分 类 号：R817.1[医药卫生—影像医学与核医学]