Asian Journal of Nuclear Medicine
亞洲核醫學雜志

Volume 1 Number 1, April 2001
Abstract

"雲克"99Tc-MDP)治療晚期類風濕關節炎多關節侵蝕、變形、嚴重功能障礙臨床報道

袁濟民
上海第二醫科大學附屬仁濟醫院核醫學科,上海 200001,中國。

目的 研究新藥雲克(U[99Tc]亞甲基二膦酸鹽)治療晚期類風濕關節炎骨侵蝕的臨床效果。方法 大劑量多療程1.0g~1.5g/月,連續給藥1~2年。結果 10例有多關節骨侵蝕嚴重功能障礙患者經"雲克"治療達一年以上後均見有不同程度的功能恢復和骨侵蝕的改善,顯效者可以行走、旅遊、生活自理或部分生活自理。3例依賴服用強的松病人可停用激素藥物或減量服用(1.25mg/天)。X片示,受損的狹窄的關節間隙增寬,侵蝕的關節面得到改善,骨質疏鬆亦見好轉。結論 被認為不可逆的晚期類風濕關節炎、嚴重骨關節病變獲得了可以逆轉的客觀反映,治療有了突破性的進展。

【關鍵字】U[99Tc]亞甲基二膦酸鹽;類風濕關節炎;骨侵蝕

Therapeutic application of 99Tc-MDP in advanced nodose rheumatoid patients with multiple arthrosis erosion and malfunctioning

YUAN Jiming, Department of nuclear medicine, Renji Hospital, The 2nd Medical University of Shanghai. Shanghai 200001, China.

Objective To evaluate clinical effect of 99Tc-MDP in treating arthrosis erosion in advanced nodose rheumatism. Methods Therapy was performed undisrupted for 1 to 2 years in each patient at a high dose of 1.0~1.5g/month. Results After more than 1 year's 99Tc-MDP therapy, 10 patients with multiple arthrosis erosion and serious malfunctioning had function recovery and arthral reformation of different extent. Patients with obvious therapeutic effects were able to walk, travel and completely or partially took care of themselves. Cortisone was prohibited or permitted at a lower dose of 1.25mg/day in 3 patients who were dependant on prednisone. As results from 99Tc-MDP therapy, X-ray photography revealed broadened arthral gap, reformation of previously eroded arthrosis and even improvement in osteoporosis. Conclusion Reversible changes resulted from 99Tc-MDP therapy showed breakthrough in treatment of advanced nodose rheumatism and serious ostearthtitis, whose pathological changes were previously considered irreversible. (Asian J Nucl Med 2001;1:31-34)

Key Words : 99Tc-MDP; Rheumatoid arthritis; Bone erosion



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