CAJ | 학술논문

目的探讨腮腺核素显像半定量分析与干燥综合征(SS)患者唇腺病理检查分级的相关性,以评价其在SS早期诊断和病情判断中的价值.方法对135例SS患者及30名健康志愿者(对照组)行常规腮腺核素显像和半定量分析,计算半定量指标:腮腺最大浓聚率(MAR)、腮腺酸刺激后最大分泌率(MSR)、酸刺激后腮腺达到最低放射性计数所需的时间(t腮腺)、酸刺激前口内活性指数(PRI)、酸刺激后口内活性指数(POI).所有患者在显像检查后均获得唇腺病理检查结果,根据病理变化分为:O,1,2,3,4级.将各病理分级组的半定量指标与对照组进行比较(单因素方差分析和q检验),并且与唇腺病理分级结果进行相关性分析.结果病理分级3级以上组与对照组比较,所有半定量指标差异均有统计学意义(q=6.79～38.64,P均<O.01);而病理l～2级组与对照组的比较,仅PRI和POI差异有统计学意义(q值分别为8.33和8.63,P均<0.01).MAR和MSR均随病理分级增加而减少.与病理分级呈负相关(r值分别为-O.679和-0.601.P均<0.01).t腮腺随病理分级增加而延长,与病理分级呈正相关(r=0.364,P<O.01).PRI和POI也随病理分级增加而明显减低,与病理分级旱负相关(r值分别为-0.724和-O.751,P<0.O1).结论腮腺核素显像有关半定量指标与SS唇腺病理改变分级有相关性,提示其可用于评价SS的病变程度和监测病情变化,而口腔相关指标对SS的早期诊断可能吏有价值.
목적 탐토시선핵소현상반정량분석여간조종합정(SS)환자진선병리검사분급적상관성,이평개기재SS조기진단화병정판단중적개치.방법 대135례SS환자급30명건강지원자(대조조)행상규시선핵소현상화반정량분석,계산반정량지표:시선최대농취솔(MAR)、시선산자격후최대분비솔(MSR)、산자격후시선체도최저방사성계수소수적시간(t시선)、산자격전구내활성지수(PRI)、산자격후구내활성지수(POI).소유환자재현상검사후균획득진선병리검사결과,근거병리변화분위:O,1,2,3,4급.장각병리분급조적반정량지표여대조조진행비교(단인소방차분석화q검험),병차여진선병리분급결과진행상관성분석.결과 병리분급3급이상조여대조조비교,소유반정량지표차이균유통계학의의(q=6.79～38.64,P균<O.01);이병리l～2급조여대조조적비교,부PRI화POI차이유통계학의의(q치분별위8.33화8.63,P균<0.01).MAR화MSR균수병리분급증가이감소.여병리분급정부상관(r치분별위-O.679화-0.601.P균<0.01).t시선수병리분급증가이연장,여병리분급정정상관(r=0.364,P<O.01).PRI화POI야수병리분급증가이명현감저,여병리분급한부상관(r치분별위-0.724화-O.751,P<0.O1).결론 시선핵소현상유관반정량지표여SS진선병리개변분급유상관성,제시기가용우평개SS적병변정도화감측병정변화,이구강상관지표대SS적조기진단가능리유개치.
Objective Labial gland biopsy is one of major diagnostic methods for Sj(o)gren's syn-drome(SS).Meanwhile,99TcmO-4 parotid scintigraphy has been proven useful for the clinical evaluation of SS.This study was performed to investigate the correlation between the two examinations and evaluate the semi-quantitative parotid scintigraphy in the early diagnosis and staging for SS patients.Methods There were 135 SS patients and 30 normal subjects as control group in this study.They all underwent 99TcmO-4 pa-rotid scintigraphy.Semi-quantitative analyses of parotid scintigraphy were conducted with parameters inclu-ding maximum accumulation ratio (MAR),maximum secretion ratio(MSR),time interval from stimulation to minimum count(tparotid),prestimulatory oral activity index (PRI) and poststimulatory oral activity index (POI).For comparison, the biopsy of labial gland was performed in each patient and the pathological se-verity was classified into grade 0,1,2,3,4 (also defined as subgroups).One-way ANOVA and q-teat were applied for the correlation analyses between the two examinations.Results There was significant difference between pathological subgroup 3 or subgroup 4 and the control in all the semi-quantitative parame-ters (q=6.79-38.64,P<0.O1).In subgroups 1 and 2,only PRI and POI showed significant changes compared with the control(q=8.33,8.63,all P<0.01).The pathological stages were negatively correla-ted with MAR(r=-0.679,P<0.01),MSR(r=-0.601,P<0.01),PRI(r=-0.724,P<0.01)and POI(r=-0.751,P<0.01),but only positively correlated with tparotid(r=0.364,P<0.01).Con-clusions Most semi-quantitative parameters of 99TcmaO-4 parotid scintigraphy may be well correlated with the pathological severity of labial gland biopsy in SS patients.Further,the semi-quantitative indices espe-eially PRI and POI may be helpful for the early diagnosis and staging of SS patients.