甲状旁腺功能亢进症患者血清生化指标与99Tcm-MIBI SPECT/CT显像的相关性研究  

Correlation between biochemical parameters and ^(99)Tc^(m)-MIBI SPECT/CT imaging in patients with hyperparathyropathy

作　　者：张曼 杜春玲[2] 李坤[2] 王路路 李睿 宋剑 李文[2] ZHANG Man;DU Chunling;LI Kun;WANG Lulu;LI Rui;SONG Jian;LI Wen(Shandong Provincal Qianfoshan Hospital,Shandong First Medical University,Jinan 250000 China;The First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Jinan 250014 China;Shandong Medical College,Jinan 250000 China)

机构地区：[1]山东第一医科大学山东省千佛山医院,山东济南250000 [2]山东第一医科大学第一附属医院(山东省千佛山医院),山东济南250014 [3]山东医学高等专科学校,山东济南250000

出　　处：《中国辐射卫生》2021年第2期233-237,共5页Chinese Journal of Radiological Health

摘　　要：目的探讨甲状旁腺功能亢进症患者血清钙、磷、甲状旁腺激素(PTH)水平与99Tcm-MIBI显像的相关性,计算血清钙、磷和PTH的Cut-off值。方法回顾性分析2017年9月-2019年9月经手术病理学确诊的甲状旁腺功能亢进患者234例,所有患者均于术前行甲氧基异丁基异腈(MIBI)显像和血清PTH、钙、磷等生化检查。结果原发性(PHPT)和继发性(SHPT)甲状旁腺功能亢进者PTH水平中位数分别为210.93(122.60~529.20)pg/mL和1842.50(1342.50~2345.00)pg/mL,两组间差异有统计学意义(Z=-10.83,P=0.000),SHPT组显著高于PHPT组。PHPT组和SHPT组血清钙水平中位数分别为2.86(2.65~3.15)mmoL/L和2.43(2.32~2.58)mmoL/L,两组间差异有统计学意义(Z=-7.52,P=0.000),PHPT组显著高于SHPT组。PHPT组和SHPT组血清磷水平中位数分别为0.80(0.64~1.03)mmoL/L和2.26(1.97~2.63)mmoL/L,两组间差异有统计学意义(Z=-10.15,P=0.000),PHPT组显著低于SHPT组。将年龄、性别、PTH值、钙值、磷值作为自变量,MIBI显像结果作为应变量,Logistic回归分析得出PTH值为PHPT组的影响因素(OR:1.012,95%CI:1.002~1.023),相关性分析得出r=0.60(P=0.000);SHPT组无相关因素。绘制PHPT组99Tcm-MIBI影像显像结果ROC曲线,对应最大曲线下面积0.91,计算Cut-off值为113.1 pg/mL。绘制PHPT组和SHPT组钙值、磷值与PTH值散点图,相关性分析得出PHPT组:钙值与PTH值具有中度相关(r=0.64,P=0.000),磷值与PTH值具有低度相关(r=-0.28,P=0.032);SHPT组:钙值与PTH值具有低度相关(r=0.17,P=0.03),磷值与PTH值无相关性(P=0.15)。结论PHPT组血清PTH水平与MIBI显像结果具有中度相关性,血清PTH水平越高MIBI显像阳性率越高,MIBI显像对应的分界值为113.1 pg/ml。PHPT组血清Ca水平与血清PTH水平具有中度相关性,而SHPT组血清Ca水平与血清PTH水平具有低度相关性。Objective To explored the correlation between levels of serum calcium,phosphorus PTH and 99Tcm-MIBI in patients with hyperparathyropathy as well as to find cut off valve of serum calcium,phosphorus and PTH.Methods A total of 234 patients with hyperparathyroidism that confirmed by operation and pathology were collected from September 2017 to September 2019.Results The median PTH levels in PHPT group and SHPT group were 210.93(122.60~529.20)pg/ml and 1842.50(1342.50~2345.00)pg/ml,respectively.There was significant difference between the two groups(Z=−10.83,P=0.000).SHPT group was significantly higher than that in PHPT group.The median of Ca level of PHPT group and SHPT group was 2.86(2.65~3.15)mmol/L and 2.43(2.32~2.58)mmol/L,respectively.There was significant difference between the two groups(Z=−7.52,P=0.000).The level of Ca in PHPT group was significantly higher than that in SHPT group.The median of P level in PHPT group and SHPT group was 0.80(0.64~1.03)mmol/L and 2.26(1.97~2.63)mmol/L respectively.There was significant difference between the two groups(Z=−10.15,P=0.000),and the PHPT group was significantly lower than the SHPT group.The age,gender,PTH and Ca and P value were taken as independent variables,and the results of MIBI imaging were used as dependent for logistic regression analysis.After screening,the influencing factor of PHPT group was PTH value(OR:1.012,95%CI:1.002~1.023),and correlation analysis showed that r=0.60(P=0.000).No related factors were found in SHPT group.ROC curves of 99Tcm-MIBI imaging results in PHPT group were drawn,corresponding to the areas under the maximum curve of 0.91,and the calculated cutoff value was 113.1 pg/mL.simple scatter plot of Ca value,P value and PTH value was drawn in PHPT group and SHPT group,and correlation analysis was performed.In PHPT group,Ca value and PTH value had moderate correlation(r=0.64,P=0.000),P value and PTH value had low correlation(r=−0.28,P=0.032);in SHPT group:Ca value and PTH value had low correlation(r=0.17,P=0.03),P value and PTH valu

关 键 词：原发性甲状旁腺功能亢进 继发性甲状旁腺功能亢进 甲状旁腺激素 99M锝甲氧基异丁基异腈 钙 磷 

分 类 号：R816.6[医药卫生—放射医学]