- 期刊
Clinical Application of On-site Prepared Technetinum-99m Human Serum Albumin for Scintigraphic Detecting of Protein-losing Enteropathy
在地標幟鎝－99m-人體血清白蛋白用於偵测蛋白質流失腸胃道病變之臨床應用
摘要
對於蛋白質流失之肠胃道病變(protein-losing enteropathy; PLE)病患，鎝－99m標幟人體血清白蛋白(human serum albumin; HAS)提供直接的診斷依據。然而，由於愛滋病或病毒性肝炎等的流行，血液制劑的安全已成爲重要的課题。先前的研究中，我們發展出以國人血清白蛋白制品於核醫驗室中在地標幟成鎝－99m-HSA，此制劑具有相當良好的標幟效率、稳定性和生物可用性。在此先驅研究中，我们應用此在地標幟的鎝－99m-HAS於疑似PLE患者以評估其應用可行性。 方法：人體血清白蛋白取自中華血液基金會，爲衛署核准之血液制品，並經感染性篩檢通過。在地標幟之鎝－99m-HAS經静脈注射於疑似PLE的患者後，以加馬閃爍摄影儀連續收取其腹部影像，並持續觀察受檢者後續反應。 結果：共有五位疑似PLE的受試者接受此檢查，其中兩位明確顯現出蛋白質流失的所在，其餘三位则未有流失病灶發現。所有受檢者均顺利完成检查，無特定不適或副作用發現。 結論：此先驅研究證實核醫實驗室在地標幟國人血漿制成之血液制劑，不僅符合聯合国世界衛生组織國血國用的原则，而且可應用於PLE病變部位之偵測、定位和追蹤，並且對病患安全有所相對性保障。
並列摘要
Background: Abdominal scintigraphy performed with technetium-99m ((superscript 99 m) Tc)-labeled human serum albumin (HSA) provides direct evidence of protein-losing enteropathy (PLE). However, because of transfusioninduced infections, the safety of serum products is a major concern. We previously developed an on-site preparation of (superscript 99 m) Tc-HSA using domestic serum products, which showed good labeling efficiency, stability, and bioavailability. The purpose of this pilot study was to initially evaluate those preparations of (superscript 99 m) Tc-labeled HSA for clinical application. Methods: HSA was locally acquired and appropriately screened for infectious diseases. (superscript 99 m) Tc-HSA was prepared according to our previous protocol. It was intravenous administration to patients with clinically suspected PLE. Sequential abdominal images were acquired by a gamma camera. Sites of obvious PLE were localized after the radiolabeled HSA was administered. Patients were monitored for adverse events. Results: Five patients with clinical suspicious of PLE were enrolled in this pilot study. Areas of protein loss were demonstrated in two patients. Another three cases, the origin of diminished serum albumin levels remained undetermined. All patients tolerated with procedure well with no specific adverse effects or major complaints. Conclusion: Scintigraphy with (superscript 99 m) Tc-HSA is noninvasive and can be used to detect, localize, and follow up cases of occult or intermittent PLE. Our pilot study demonstrated that this on-site prepared (superscript 99 m) Tc-HSA was appropriate for clinical application. Procedure of on-site radiolabeling from the native serum product was easy to be performed and achieved good labeling efficiency and bioavailability. It might also reduce the incidence of transfusion-induced infections. This technique resulted in good image quality and improved patient safety.