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目的研究99Tcm-奥曲肽眼眶显像在判断甲状腺相关眼病(TAO)患者眼部炎性反应活动度中的临床价值。方法根据临床活动度评分(CAS)标准,将30例TAO患者分为活动组和非活动组,11例正常志愿者为对照组。所有对象行99Tcm-奥曲肽眼眶断层显像,并计算眼眶奥曲肽摄取比值(UR)。6例活动组患者于抗炎治疗后进行了二次显像。结果3组眼眶的奥曲肽UR均数分别为1·40±0·18、1·15±0·10及1·07±0·20,活动组与非活动组、对照组两两相比,差异均有统计学意义(均P<0·001);非活动组与对照组相比,差异无统计学意义(P>0·05)。所有TAO患者的UR与其CAS具有良好的相关性(rall=0·859,P<0·001)。对活动组患者的治疗前后UR比较,差异有统计学意义(t=4·39,P=0·007)。治疗前后CAS比较,差异有统计学意义(Z=-5·51,P<0·001),表明治疗后评分降低,治疗有效。结论99Tcm-奥曲肽眼眶显像可帮助临床医师判断TAO炎性反应活动度,为制订治疗方案提供依据,并可用于疗效评价。
Objective To investigate the clinical value of 99Tcm-octreotide orbital imaging in judging ocular inflammatory response in patients with thyroid-associated ophthalmopathy (TAO). Methods According to the criteria of clinical activity score (CAS), 30 patients with TAO were divided into active group and inactive group and 11 normal volunteers as control group. All subjects underwent 99Tcm-octreotide orbital tomography, and the orbital octreotide uptake ratio (UR) was calculated. Six patients in the active group underwent secondary imaging after anti-inflammatory treatment. Results The mean ocularotide levels of octreotide in the three groups were 1.40 ± 0.18, 1.15 ± 0.10 and 1.10 ± 0.20, respectively. There was no significant difference between the active group and the control group (P <0.001). There was no significant difference between inactive group and control group (P> 0.05). The UR of all patients with TAO had a good correlation with their CAS (rall = 0.859, P <0.001). There was significant difference in UR between before and after treatment in active group (t = 4.39, P = 0.007). Before and after treatment CAS comparison, the difference was statistically significant (Z = -5 · 51, P <0.001), indicating that after treatment, the score decreased, the treatment is effective. Conclusion 99Tcm-octreotide orbital imaging can help clinicians to determine the activity of TAO inflammatory response, to provide a basis for the development of treatment options, and can be used for evaluation of the curative effect.