^99Tc^m-MDP SPECT／CT全身骨显像与血清学标志物检测对类风湿性关节炎的诊断价值  

Diagnostic Values of Whole Body Bone Imaging by ^(99)Tc^m-MDP SPECT/CT and Serological Markers for Rheumatoid Arthritis

作　　者：郭佳[1] 王治国[1] 郝珊瑚[1] 刘凤敏[1] 张国旭[1] GUO Jia, WANG Zhi- guo, HAO Shan- hu, LIU Feng- min, ZHANG Guo- xu(Department of Nuclear Medicine, General Hospital of Shenyang Military Area Command, Shenyang 110016, Chin)

机构地区：[1]原沈阳军区总医院核医学科,辽宁沈阳110016

出　　处：《标记免疫分析与临床》2018年第3期297-299,共3页Labeled Immunoassays and Clinical Medicine

基　　金：辽宁省自然科学基金(编号:20170540952)

摘　　要：目的探讨99Tcm-MDP SPECT/CT全身骨显像与相关血清学标志物(抗CCP抗体、RF及CRP)检测对类风湿性关节炎的诊断价值。方法回顾性分析2017年1月至2017年9月在我科进行99Tcm-MDP SPECT/CT全身骨显像的疑似类风湿性关节炎患者164例,其中男72例,女92例,平均年龄48~71岁,病程0.5~2年,所有入选患者均有相关血清学检测指标(抗CCP抗体、RF及CRP水平),最终诊断以2010年美国风湿病协会和EUALR指定的RA诊断分类标准为依据,对全身骨显像及血清学指标的诊断效能进行比较分析。结果 164例受检者中最终诊断类风湿性关节炎患者128例,血清学检测灵敏度59.38%,特异性58.33%;99Tcm-MDP SPECT/CT全身骨显像灵敏度77.34%,与血清学检测比较具有统计学意义(P<0.05);特异性55.56%,两者差异无统计学意义。结论在类风湿性关节炎的诊断中,99Tcm-MDP SPECT/CT全身骨显像的诊断灵敏度优于血清学检测;且99Tcm-MDP SPECT/CT全身骨显像更易于评价全身关节受累情况。Objective To investigate the diagnostic values of whole body bone imaging by 99Tcm-MDP SPECT/CT and related serological markers （anti-CCP antibody, RF and CRP）in the diagnosis of rheumatoid arthritis. Methods A total of 164 patients with suspected rheumatoid arthritis who underwent 99Tcm-MDP SPECT/CT whole-body bone imaging in our department from January 2017 to September 2017 were retrospectively analyzed, including 72 males and 92 females, with an average age of 48 -71 years old, duration of 0.5 to 2 years. All enrolled patients have relevant serological test indicators （anti-CCP antibody, RF and CRP levels）, and the final diagnosis was based on the 2010 American College of Rheumatology and EUALR designated RA diagnostic classification criteria. The diagnostic performance of whole body bone imaging and serological markers were then compared. Results Among the 164 cases, 128 cases of patients were confirmed. The sensitivity of serological detection was 59.38% and the specificity was 58.33% ,while the sensitivity of 99Tcm-MDP SPECT/CT bone imaging was 77.34% with a statistically significant difference （ P 〈 0.05 ）, while the specificity was 55.56%, with no significant difference between the two groups. Conclusion In the diagnosis of rheumatoid arthritis, the sensitivity of whole body bone imaging by 99Tcm-MDP SPECT/CT is superior to the serological testing, furthermore, the whole body bone Imaging was better for assessing the systemic involvement.

关 键 词：类风湿性关节炎 抗CCP抗体 C反应蛋白 类风湿因子 SPECT/CT 全身骨显像 

分 类 号：R593.22[医药卫生—内科学] R817.4[医药卫生—临床医学]