Temporal Evolution of The Intensity of Inflammatory Bowel Disease in Children: Correlation Of a Semi-Quantitative Analysis of Bowel Uptake in White Blood Cells Scintigraphy with Biological Parameters

兒童發炎性腸道疾病的瞬時病情演變：以標幟白血球造影半定量分析腸攝取與生物學參數之相關性

Jean-Louis Alberini ； Martin Charron ； Jonathan Markowitz ； Dan Von Allmen ； Peter Hurh

《核子醫學雜誌》 16卷1期 (2003/03) Pp. 1-7

https://doi.org/10.6332/ANMS.1601.001

摘要

背景：標幟白血球造影(WBCS)已被公認爲精確診斷發炎性腸道疾病(IBD)的方法。病情追蹤時常以臨床與生物學參數來評估IBD的程度，但相當不準確。爲了评估WBCS作爲IBD病童病情追蹤的角色，我們回溯研究由WBCS獲得之半定量指標—掃描活度指標(SAI)與两種不同時間量測的生物學參數進行比對。方法：總計17位IBD病童（14位Crohn氏病患者，3位潰瘍性結腸炎患者：平均年龄13.5歲）共進行34次WBCS。連續兩次WBCS間隔時間平均爲14個月（範围爲5-27個月）。注射鎝-99m-HMPAO標幟白血球後30分鐘及2-3小時進行WBCS。比较8個腸區段的攝取活度與骨髓、肝臟及脾臟等器官的生理攝取量以計算其SAI值。SAI反映所有腸區段的總攝取活度。比较SAI演變與紅血球沉降速率(ESR)、白血球數(WBC)及血小板數(PLAT)之關聯性。結果：SAI降低、不變與增加之病人數者分別爲11位、3位與3位。ESR降低、不變與增加之病人數分別爲9位、4位與4位。WBC及PLAT未改變之病人數分別爲7位與11位。11位病人的SAI演變與ESR有相關性。兩位病人呈現不吻合，其SAI改善但ESR變壞。一位病人之SAI變壞，但ESR卻好轉。SAI與WBC或PLAT间無明顯相關性。結論：由於大多數病人的WBC與PLAT值呈現穩定状態，以此類參數用於評估IBD病情有其限制。WBCS得到的SAI結合ESR看來似乎是一項有用的方式用以評估IBD的瞬時病情。

關鍵字

發炎性腸道疾病 ； 標幟白血球造影 ； 半定量指標 ； 生物學參數

並列摘要

Background: White Blood Cells Scintigraphy(WBCS)has shown to be an accurate method for the diagnosis of Inflammatory Bowel Disease(IBD).Clinical and biological parameters are used to evaluate the intensity of IBD during the follow-up, but are relatively inaccurate. In the order to evaluate the role of WBCS in the follow up of children with IBD, we retrospectively studied the correlation between the evolution of the WBCS results using a semi-quantitative index, the Scan Activity Index(SAI),and results of different biological parameters measured at two different times during the follow-up. Methods: Thirty-four WBCS were performed in 17 children(mean age:13.5 years)with IBD(14 Crohn'sDisease,3 ulcerative colitis).The mean interval time between 2 sequential WBCS was 14 months(range:5-27 months).WBCS were performed at 30 min and 2-3h after injection of(superscript 99m)Tc-HMPAO labeled leukocytes. The SAI was measured by comparing the intensity of uptake in 8 bowel segments with the physiologic uptake present in the bone marrow, liver and spleen. SAI corresponds to the sum of the intensity of uptake for all segments. The evolution of the SAI was correlated with those of erythrocyte sedimentation rate(ESR),WBC(WBC)and platelets(PLAT)counts Results: The SAI value was decreased, unchanged and increased in 11,3 and 3 patients, respectively. The ESR was decreased, unchanged and increased respectively in 9,4 and 4 patients. The counts of WBC and PLAT were unchanged in 7 and 11 patients, respectively. A correlation was observed between the evolution of SAI and ESR in 11 patients. Discordant data were observed for 2 patients with an improvement of SAI and worsening of ESR and the opposite for 1 patient. No significant correlation was found between SAI and WBC or PLAT. Conclusion: The stability of WBC and platelets values observed in most of the patients emphasizes the limitation for the use of these parameters to assess the evolution of the intensity of IBD.WBCS using SAI, in association with ESR, seems to be a useful tool to evaluate the temporal evolution of intensity of IBD.

並列關鍵字

inflammatory bowel disease ； white blood cells scintigraphy ； semi-quantitative index ； biological parameters