摘要
目的以双血浆法99Tcm-二亚乙基三胺五乙酸(99Tcm-DTPA)清除率为参考标准,评价肾动态显像法测定肾小球滤过率在慢性肾功能衰竭(chronic renal failure,CRF)患者的临床应用。方法24例健康志愿者(对照组)和54例慢性肾衰患者(慢性肾衰组)均行肾动态显像,计算肾脏GFR,即Gates法(gGFR);同时于注射显像剂99Tcm-DTPA2,4h后各抽血4ml,分离血浆1ml,测量其放射性计数,计算2,4h99mTc-DTPA的血浆清除率(双血浆法-tGFR)。两种方法所得数据均用体表面积标准化,比较其相关性。结果①正常组gGFR和tGFR相比无统计学差异(P>0.05)。慢性肾衰组当GFR<30ml/min时,gGFR均显著高于tGFR(P<0.05),tGFR越低,偏差越明显。②散点图描绘可见在对照组gGFR与tGFR呈正相关(r=0.567,P=0.005);GFR<30ml/min时,gGFR与tGFR之间有相关关系,但相关性差(r=0.361,P=0.026)。结论对于正常人(90ml/min<GFR<120ml/min),肾动态显像法测得的GFR能够可靠地反映肾功能的变化,与双血浆法测得的GFR基本相符合。但在慢性肾衰患者中(GFR<30ml/min),肾动态显像法测量GFR结果的准确性差,不宜作为临床的参考标准。
Objective To estimate the clinical application of 99mTc-DTPA dynamic renal imaging（ Gates method）for detecting the GFR of patients with chronic renal failure（CRF） with 99mTc-diethylene triamine pentaacetic acid（DTPA） plasma clearance by dual plasma method as the gold standard. Methods Fifty-four patients with CRF were chosen as CRF group, and twenty-four healthy volunteers as controls. The renal scintigraphic images of controls and CRF patients were processed according to standard procedure（ Gates method） to obtain gGFR. After injecting 99mTc-DTPA for 2 h and 4 h, the radioactivity was measured, and then tGFR was calculated by two-sample method. The results by two methods were all standardized with the body surface area, and their correlation was compared. Results （1）In control group, there was no significant difference between gGFR and tGFR（ P 〉 0.05 ）. For the CRF patients with GFR 〈 30 ml/ min, gGFR was significantly higher than tGFR（ P 〈 0.05 ）. The lower the tGFR was, the more the deviation between gGFR and tGFR was. （2）In control group, there was a positive correlation between gGFR and tGFR （ r = 0. 567, P = 0. 005 ）. When GFR 〈 30 ml/min, there was a correlation between gGFR and tGFR （ r = 0. 361 ,P = 0. 026）. Conclusion （1）For the normal controls （ 90 ml/min 〈 GFR 〈 120 ml/min） , GFR obtained by 99mTc-DTPA dynamic renal imaging （Gates method）is reliable for identifying the changes of renal function, and shows a consistent tendency with GFR obtained by two-sample method. （2）For the CRF patients with GFR 〈 30 ml/min, ^99Tc^m-DTPA dynamic renal imaging（ Gates method）is less precise and not suitable to be the clinical reference standard.
出处
《山西医科大学学报》
CAS
2009年第12期1108-1110,共3页
Journal of Shanxi Medical University
关键词
慢性肾衰
肾小球滤过率
双血浆法
肾动态显像法
chronic renal failure
glomerular filtration rate
two-sample method
^99Tc^m-DTPA dynamic renal imaging
作者简介
闫君：女，1973—10生，在读硕士，主治医师，E-mail：yanjun0352@126．com．
通讯作者，E-mail：lixianfeng-lxf@263．net
