首页|慢性肾病继发性甲状旁腺功能亢进症术后骨饥饿综合征99Tcm-MIBI骨摄取

慢性肾病继发性甲状旁腺功能亢进症术后骨饥饿综合征99Tcm-MIBI骨摄取

99Tcm-MIBI Bone Uptake on Hungry Bone Syndrome in Renal Hyperparathyroidism After Parathyroidectomy

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目的 分析慢性肾病继发性甲状旁腺功能亢进症行甲状旁腺切除术后骨饥饿综合征(HBS)患者 99Tcm-甲氧基异丁基异腈(MIBI)骨摄取情况,为临床诊疗提供参考.资料与方法 回顾性分析2014年6月—2021年12月于南通大学附属江阴医院行甲状旁腺切除术的 106 例继发性甲状旁腺功能亢进症的影像及临床资料,采用视觉评估分析甲状旁腺平面显像骨骼显像剂摄取情况,根据术后有无发生HBS分为HBS组和非HBS组.比较两组患者临床特征、实验室指标及 99Tcm-MIBI骨摄取的差异.结果 106例中,42例(39.62%)99Tcm-MIBI骨摄取阳性,多表现为弥漫性骨骼显像剂摄取,以胸骨、锁骨及肋骨多见.与非HBS 组相比,HBS 组的年龄较小(t=-3.058),碱性磷酸酶和甲状旁腺激素水平较高(Z=-5.148、-2.218),血清校正钙较低(Z=-2.102),99Tcm-MIBI骨摄取的阳性率及部位数较高[50%比28%,2(1,3)比1(1,1);χ2=5.344,Z=-2.970],差异均有统计学意义(P均<0.05).结论 慢性肾病继发性甲状旁腺功能亢进症行甲状旁腺切除术后发生HBS患者的碱性磷酸酶和甲状旁腺激素水平更高,更易发生 99Tcm-MIBI骨摄取.
Purpose To investigate the value of 99Tcm-(methoxyisobutvlisonitrile,MIBI)bone uptake on hungry bone syndrome(HBS)in renal secondary hyperparathyroidism(SHPT)after parathyroidectomy.Materials and Methods From June 2014 to December 2021,106 renal SHPT patients who underwent successful parathyroidectomy in Jiangyin Hospital Affiliated Nantong University were retrospectively enrolled.Visual analysis was used to evaluate the abnormal bone uptake of 99Tcm-MIBI.The patients were divided into HBS group and non-HBS group based on whether occurred HBS.The clinical features,laboratory indicators and 99Tcm-MIBI bone uptake were compared between the two groups.Results Of 106 renal SHPT patients,42(39.62%)patients with bone uptake on visual assessment,showed diffusely increased tracer accumulation,particularly in sternum,clavicle and ribs.The age in HBS group was younger than that in non-HBS group(t=-3.058),the alkaline phosphatase and parathyroid hormone level in HBS group were higher than that in non-HBS group(Z=-5.148,-2.218),the serum corrected calcium in HBS group was lower than that in non-HBS group(Z=-2.102),the positive rate and number of 99Tcm-MIBI bone uptake in HBS group was 50%and 2(1,3),which was higher than that of 28%and 1(1,1)in non-HBS group(χ2=5.344,Z=-2.970),respectively,all showed statistically significant difference(all P<0.05).Conclusion Renal SHPT patient with HBS after parathyroidectomy is commonly related to a high level of alkaline phosphatase and parathyroid hormone,and more likely to develop abnormal 99Tcm-MIBI bone uptake.

Hyperparathyroidism,secondary99Tcm-sestamibiHungry bone syndromeHypocalcemiaParathyroid hormoneAlkaline phosphataseChronic kidney disease-mineral and bone disorder

陈则君、周斌、付晶晶、伍超群、邵清、黄钱焕、王峰

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南通大学附属江阴医院核医学科,江苏 江阴 214400

南通大学附属江阴医院乳甲外科,江苏 江阴 214400

南京医科大学附属南京医院、南京市第一医院核医学科,江苏 南京 210006

甲状旁腺功能亢进症,继发性 99锝m-甲氧基异丁基异腈 骨饥饿综合征 低钙血症 甲状旁腺激素 碱性磷酸酶 慢性肾脏病-矿物质和骨异常

江苏大学临床医学科技发展基金资助项目

JLY2021071

2024

10.3969/j.issn.1005-5185.2024.07.006

中国医学影像学杂志
中国医学影像技术研究会

中国医学影像学杂志

CSTPCD北大核心
影响因子：1.37
ISSN：1005-5185
年,卷(期)：2024.32(7)
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