CAJ | 학술논문

目的：探讨核素骨显像预测99Tc-MDP治疗类风湿关节炎效果的临床价值。方法2012年6月~2014年10月，选取诊断明确的39例活动性类风湿关节炎患者在99Tc-MDP治疗前采用放射性核素骨骼显像剂(99mTc-MDP)对病变关节进行显像，利用感兴趣区(ROI)技术计算病变关节摄取比值(T/N)。99Tc-MDP治疗前及治疗后6周记录患者的关节压痛数、关节肿胀数、晨僵时间，红细胞沉降率(ESR)、C反应蛋白(CRP)，将患者分为显效组、有效组及无效组，比较3组的T/N值，同时按T/N值分为高摄取、低摄取组，并进行疗效比较。结果不同疗效组的T/N值差异有统计学意义(P<0.05)，显效组的T/N值最高，无效组的T/N值最低。高摄取、低摄取组的疗效差异有统计学意义，高摄取组的疗效优于低摄取组(P<0.05)。结论核素骨显像在预测99Tc-MDP治疗类风湿关节炎效果方面有较高的临床价值，对临床医师优化治疗方案有很好的指导作用。
목적：탐토핵소골현상예측99Tc-MDP치료류풍습관절염효과적림상개치。방법2012년6월~2014년10월，선취진단명학적39례활동성류풍습관절염환자재99Tc-MDP치료전채용방사성핵소골격현상제(99mTc-MDP)대병변관절진행현상，이용감흥취구(ROI)기술계산병변관절섭취비치(T/N)。99Tc-MDP치료전급치료후6주기록환자적관절압통수、관절종창수、신강시간，홍세포침강솔(ESR)、C반응단백(CRP)，장환자분위현효조、유효조급무효조，비교3조적T/N치，동시안T/N치분위고섭취、저섭취조，병진행료효비교。결과불동료효조적T/N치차이유통계학의의(P<0.05)，현효조적T/N치최고，무효조적T/N치최저。고섭취、저섭취조적료효차이유통계학의의，고섭취조적료효우우저섭취조(P<0.05)。결론핵소골현상재예측99Tc-MDP치료류풍습관절염효과방면유교고적림상개치，대림상의사우화치료방안유흔호적지도작용。
Objective To explore the clinical value of nuclide bone imaging forecasting the effect of 99Tc-MDP treating rheumatoid arthritis. Methods From June 2012 to October 2014,39 patients with active rheumatoid arthritis diagnosed clearly were taken images for affected joints by radionuclide bone imaging agent (99mTc-MDP) before 99Tc-MDP treat-ment.The uptake ratio (T/N) of affected joints was calculated by region of interest (ROI) technique.Before 99Tc-MDP treatment and after 6-week therapy,joint tenderness number,joint swelling number,time of morning stiffness,erythrocyte sedimentation rate (ESR),and C-reactive protein (CRP) were recorded.They were divided into effective markedly group, effective group and ineffective group.T/N value among three groups was compared.According to T/N value,they were di-vided into high uptake group and low uptake group,in which the therapeutic effect was compared. Results There was a statistical difference of T/N value in different therapeutic group (P<0.05),and T/N value in effective markedly group was highest,and lowest in the ineffective group.There was a statistical difference of curative effect between high uptake group and low uptake group,and the curative effect in high uptake group was better than that of low uptake group (P<0.05). Conclusion Nuclide bone imaging has higher clinical value in forecasting effect of 99Tc-MDP treating rheumatoid arthritis and has a better guidance role for clinicians optimizing therapeutic regimen.