摘要
目的以99mTc-DTPA血浆清除率为标准,评价99mTc-DTPA肾动态显像检查在检测肾小球滤过率(GFR)中的应用价值。方法选择慢性肾脏病患者197例,年龄均>18岁,诊断均符合美国NKF-K／DOQI关于慢性肾脏病定义。排除肾功能急性恶化因素、水肿、肢体缺如、心功能不全。记录身高、体重。肘静脉“弹丸”式注射99mTc-DTPA 111 MBq后即刻行肾动态图像采集 120帧,计算双肾GFR,即Gates法,同时于注射后2、4 h各抽血4 ml,分离血浆1 ml,测量其放射性计数,计算99mTc-DTPA的血浆清除率(双血浆法),所测数值均用体表面积标准化。按双血浆法所测得的GFR值将患者分成3组:A组77例,GFR<30 ml·min-1·(1．73 m2)-1;B组74例, 30 ml·min-1·(1．73 m2)-1≤GFR<90 ml·min-1·(1．73 m2)-1;C组46例,GFR≥90 ml·min-1·(1．73 m2)-1。分别行肾动态显像法与双血浆法所测值之间的相关分析。结果肾动态显像法及双血浆法所测3组GFR[单位:ml·min-1·(1．73 m2)-1]分别为:A组(27．08±12．14)比(17．68±5．66);B组 (63．18±23．59)比(51．95±16．81);C组(107．28±27．36)比(117．96±24．17)。2者间的相关系数分别为rA=0．286(P=0．012);rB=0．804(P<0．01);rC=0．473(P<0．01)。结论 99mTc-DTPA肾动态显像检查适用于轻、中度肾功能不全患者GFR的评估,但在重度肾功能不全患者中,其测量结果的准确性有待进一步提高。
Objective To evaluate the application of ^99mTc-DTPA renography in the determination of GFR. Methods One hundred and ninety-seven patients with primary or secondary chronic kidney disease participated in this study. A 3 mci（111 MBq）/0.5 ml dose of ^99mTc-DTPA was injected as a bolus in an antecubital vein. Renal scintigraphic images were collected immediately and the images were processed according to standard procedure （Gates method）to obtain GFR. Four ml of blood was withdrawn 2 h and 4 h postinjection respectively and radioactivity of 1 ml plasma was measured. GFR was calculated by the formula of two-sample method. The results by two methods were all standardized with the body surface. The patients were divided into three subgroups according to the GFR obtained by two-sample method and the correlation between two methods was analysed respectively. Results The GFR[ml·min^-1· （1.73 m^2） ^-1]obtained from Gates method and two-sample method was displayed as follows：group A： 27.08±12.14 vs. 17.68±5.66; group B： 63.18±23.59 vs. 51.95±16.81; group C： 107.28±27.36 vs. 117.96±24.17. The correlation coefficients of three subgroups were as follows： rA=0.286（P = 0.012）; rB=0.804（P 〈 0.01）; rC=0.473（P 〈 0.01）. Conclusion Gates method is acceptable for evaluating the GFR in patients with normal to moderately diminished renal function, but it is less precise in those with severe renal insufficiency.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2006年第5期266-270,共5页
Chinese Journal of Nephrology
