CAJ | 학술논문

目的探讨唾液腺动态显像（salivary gland scintigraphy, SGS）对疑为干燥综合征口干患者唾液腺功能受损的诊断评价，并探讨定量功能参数的临床意义。方法疑为干燥综合征口干患者22例行Tc99mO4- SGS，通过肉眼影像、时间-放射性曲线和功能参数定量分析（前3min的初始摄取率UR1-3min、第18分钟最大摄取比值UR18 min，最小排泌时间Tmin）评价唾液腺功能受损情况，对照组8例。功能受损程度不同组与对照组间各功能参数的比较采用方差分析；并依据抗SSA/SSB抗体、抗ANA抗体、抗ds-DNA抗体和RF（类风湿因子）是否阳性，比较唾液腺功能受损情况。结果（1）SGS显示唾液腺功能受损为82%（18/22），左右侧腮腺或颌下腺基本同步受损；功能正常为18%（4/22）。功能重度受损组与其他组间UR1-3 min、UR18 min均有统计学差异；功能正常组、中度受损组与对照组间UR18 min有统计学差异；功能正常组与对照组Tmin无统计学差异,功能中及重度受损组无或极少量排泌。（2）抗ds-DNA抗体均阴性，抗SSA/SSB抗体、抗ANA抗体及RF阳性分别为8、10和8例，抗SSA/SSB抗体阳性组和阴性组在唾液腺功能受损程度不同组间具有统计学差异。结论（1）SGS能敏感的发现口干患者唾液腺功能受损情况，但应将摄取和排泌功能分开评价；UR1-3 min、UR18 min和Tmin分别是评价唾液腺摄取和排泌功能不同程度受损的灵敏指标。（2）SSA/SSB自身抗体阳性者，唾液腺功能受损程度较重。
목적탐토타액선동태현상（salivary gland scintigraphy, SGS）대의위간조종합정구간환자타액선공능수손적진단평개，병탐토정량공능삼수적림상의의。방법의위간조종합정구간환자22례행Tc99mO4- SGS，통과육안영상、시간-방사성곡선화공능삼수정량분석（전3min적초시섭취솔UR1-3min、제18분종최대섭취비치UR18 min，최소배비시간Tmin）평개타액선공능수손정황，대조조8례。공능수손정도불동조여대조조간각공능삼수적비교채용방차분석；병의거항SSA/SSB항체、항ANA항체、항ds-DNA항체화RF（류풍습인자）시부양성，비교타액선공능수손정황。결과（1）SGS현시타액선공능수손위82%（18/22），좌우측시선혹합하선기본동보수손；공능정상위18%（4/22）。공능중도수손조여기타조간UR1-3 min、UR18 min균유통계학차이；공능정상조、중도수손조여대조조간UR18 min유통계학차이；공능정상조여대조조Tmin무통계학차이,공능중급중도수손조무혹겁소량배비。（2）항ds-DNA항체균음성，항SSA/SSB항체、항ANA항체급RF양성분별위8、10화8례，항SSA/SSB항체양성조화음성조재타액선공능수손정도불동조간구유통계학차이。결론（1）SGS능민감적발현구간환자타액선공능수손정황，단응장섭취화배비공능분개평개；UR1-3 min、UR18 min화Tmin분별시평개타액선섭취화배비공능불동정도수손적령민지표。（2）SSA/SSB자신항체양성자，타액선공능수손정도교중。
ObjectiveTo investigate a semi-quantitative method of evaluating salivary gland function in patients with xerostomia.Methods 22 patients with xerostomia from suspected Sj?gren’s syndrome underwent Tc99m-pertechnetate salivary gland scintigraphy(SGS). Visual assessment of the dynamic images, time-activity curves, uptake rate at 1-3 minutes(UR1-3min)and 18 minutes (UR18min), gland to background ratio at 18 minutes, and time to peak counts(Tmin)were determined. 8 patients who underwent thyroid scintigraphy were included as the control group. The analysis of variance method was used to compare the parameters among the two groups.Results Salivary dysfunction was detected on 18/22(82%)patients and 4/22(18%)of patients were normal. The bilateral submandibular glands were affected simultaneously with the parotid glands. There was significant difference in the UR1-3min and UR18min of patients with severe salivary dysfunction and other groups, in the UR18min of patients with normal function, moderate dysfunction and control group. There was no significant difference in the Tmin between patients with normal function and control group. Salivary gland excretion was considerably decreased in the moderate and severe dysfunction groups. Antibody against ds-DNA was negative in all patients. Antibodies against SSA/SSB(8), ANA(10), and RF(8)were positive. There was significant difference in the degree of salivary gland dysfunction between the groups with and without antibodies against SSA/SSB.Conclusion SGS is sensitive and accurate for diagnosing salivary gland dysfunction in patients with xerostomia. Salivary gland dysfunction was aggravated by antibody against SSA/SSB.