再生障碍性贫血全身骨髓显像与预后的分析  

Analysis of bone marrow scintigraphy and prognosis in aplastic anemia

作　　者：刘勇[1] 张一帆[1] 夹访贤[1] 康福[1] 贾士铨[1] 

机构地区：[1]山东大学第二医院核医学科,济南250033

出　　处：《临床血液学杂志》2002年第5期204-205,共2页Journal of Clinical Hematology

摘　　要：目的 :利用99Tcm 硫胶体骨髓显像对不同类型再生障碍性贫血 (再障 )显影骨髓进行半定量分析 ,并探讨与预后的关系。方法 :观察 2 7例重型再障 (SAA)及 2 5例慢型再障 (CAA) 99Tcm 硫胶体全身骨髓显像分布类型 ,按骨髓分布及活性分级计算显影骨髓量值 (M ) ,一年内重复显像并随访 3年。结果 :SAA全身骨髓分布不均匀及灶状增生现象少见 ,骨髓不显影及总量减少者占 73 .1 % ,SAA Ⅰ型及SAA Ⅱ型骨髓M值分别为 1 .39±1 .68;1 .81± 2 .0 2 ,均明显低于CAA(3 .91± 1 .39;t =5 .2 5及 4 .2 0 ,P <0 .0 0 1 ) ,1年内骨髓分布类型及显影骨髓量无明显改变。当M值 >3时 ,患者 3年治疗有效率为 80 .0 % ;当M值≤ 3时 ,患者 3年治疗有效率为 1 4 .8% ;M值≤ 1时 ,患者死亡率占 93 .3 %。结论 :结合M测定及显像骨髓分布特点有助于再障分型的进一步确定 。Objective:To analyse the prognosis of aplastic anemia with semiquantitative bone marrow scintigraphy.Methods:Bone marrow scintigraphy using 99 Tc m sulfur colloid was performed in severe aplastic anemia (SAA) 27 cases and chronic aplastic anemia (CAA) 25 cases.The semiqantitative assessment of 99 Tc m SC uptake was done according to activity score and distribution over whole bone marrow.Repeat imaging within one year and follow up data in three years was analysed.Results:Patch distribution and focal hematopoiesis was rare founded in SAA patients.Marrow semiquantitative score in SAA Ⅰ (M= 1.39 ± 1.68 and 1.81 ± 2.02 ) was much lower than CAA (M= 3.92 ± 1.39 ; t= 5.25 and 4.20 ,P< 0.001 ). No obviously changes in marrow distribution pattern and (M) score were noticed within one year.Those cases with a low score (M≤1), 93.3 % of patients died in three years.Conclusion:Diminished bone marrow volume correlates well with poor prognosis in aplastic anemia.

关 键 词：放射性核素显像 再生障碍性贫血 全身骨髓显像 预后 

分 类 号：R556.5[医药卫生—血液循环系统疾病] R817.42[医药卫生—内科学]