Graves眼病患者生长抑素受体闪烁显像应用价值.docVIP

Graves眼病患者生长抑素受体闪烁显像应用价值 　 作者：赵荣　汪静　邓敬兰　梁晓燕　曾瑾　王江 【摘要】 　　目的：探讨99mTc-OCT生长抑素受体显像在活动期Graves眼病（GO）免疫治疗中的价值。方法：采用直接法标记制备99mTc-OCT，纸层析法测定标记率。GO患者15例，健康志愿者4例为正常对照组。注射99mTc-OCT 740MBq，4h后进行头部SPECT＋CT断层和左、右侧位平面显像，次日所有患者给予强的松(30mg/d，分3次服用，疗程为1mo)治疗后再次行99m Tc-OCT显像。测定2次显像眼眶（O）与枕部（OC）的感兴趣区（ROI）放射性计数及计算双侧眼眶（O）/枕叶（OC）放射性比值。计算GO患者治疗前、后的眼病指数（OI）,进行其临床活动度的评价。结果：活动期GO患者12例治疗前O/OC比值为(1.64±0.13)，显著高于正常对照（1.16±0.04）及治疗后(1.21±0.09)(P lt;0.05)；其治疗后O/OC比值及两者与对照组比较无显著性差别 (P＞0.05)。非活动期GO患者3例治疗前、后O/OC比值与对照组比较差别无显著性(P＞0.05)。结论：活动期GO患者眼眶明显摄取99mTc-OCT，表明99m Tc-OCT显像可作为GO患者选择激素治疗及评价疗效的客观而可靠的指标。 【关键词】 Graves眼病　生长抑素受体　单光子发射型计算机断层显像（SPECT）　99m锝　奥曲肽 　　Applied value of somatostatin receptor scintigraphy in patients with Graves’ ophthalmopathy AbstractAIM: To investigate the evaluation of orbital somatostatin receptor scintigraphy with 99mTc-OCT in patients with activity Graves’ ophthalmopathy’s response to corticosteroid therapy. METHODS: OCT, a somatostatin analog, was labeled with 99mTc by a direct method. The compound’s labeling efficiency was confirmed by paper chromatography. There were 15 patients with Graves’ ophthalmopathy (GO) and 4 volunteers (control group, CG) without eye disease or GO in the study. Single photon emission computed tomography (SPECT), computed tomography (CT) and left/right lateral position planar imaging of the head were obtained 4 hours after the i.v. injection of 740MBq of 99mTc-OCT, corticosteroid therapy (methylprednisolone,10mg qo t i d. for 1 month) was given for all patients at the next day. In all patient SRS was performed again after 1 month. Radioligand uptake within each orbit (O) and occipital (OC) was measured using the region of interests (ROI) method and the O-to-OC ratio was determined before and after corticosteroid treatment. Clinical activity of GO was evaluated before and after treatment by calculating the ophthalmopathy index (OI). RESULTS: A significant change of O/OC ratio was observed between pre- and post-treatment in 12 patients with active GO