^99mTc—DTPA肾动态显像在IgA肾病慢性肾功能不全患者的临床应用  

Clinical application of renal dynamic imaging with ^99m Tc-DTPA in IgA Nephropathy with chronic renal failure

作　　者：李贞琼[1] 傅玲[1] 高再荣[2] 朱红艳[1] 刘建社[1] 邓安国[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院肾内科,武汉 [2]华中科技大学同济医学院附属协和医院核医学科,武汉

出　　处：《临床肾脏病杂志》2006年第4期151-153,共3页Journal Of Clinical Nephrology

摘　　要：目的探讨^99mTc-DTPA肾动态显像在IgA肾病（kAN）慢性肾功能不全患者病情监测及预后判断时的应用价值。方法23例经肾活检确诊为IgAN的患者行常规^99mTc-DTPA肾动态显像，测定肾小球滤过率（GFR，包括总GFR和分肾GFR），同时行肾活检按Lee氏分级标准将肾脏病理改变分级，Katafuchi积分标准对患者的肾脏病理损害，包括肾小球损害、肾小管间质损害和血管损害进行积分，将积分与上述显像指标（GFR）进行相关分析。结果随着病理分级增高，GFR趋于降低，各级组间比较差异有显著性意义（P〈0．05或P〈0．01）；相关分析示GFR与肾脏病理总积分、肾小球损害（尤其是节段损害和全球硬化）、小管间质（尤其是间质纤维化和肾小管萎缩）及血管损害呈负相关（P〈0．05或P〈0．01）；在临床指标方面，GFR与血清肌酐和尿蛋白定量及血压（收缩压和舒张压）呈负相关（P〈0．05或P〈0．01）。结论通过^99mTc-DTPA肾动态显像获得的GFR与IgA肾病肾脏病理学改变及临床指标关系密切，其在IgA肾病患者病情监测、指导治疗及预后判断中具有重要临床应用价值。Objective To investigate the clinical value of renal dynamic imaging with ^99mTc-DTPA in the disease monitoring and prognosis predicting in IgA nephropathy. Method 23 patients of renal biopsy-proven IgAN accepted the renal dynamic imaging with ^99mTc-DTPA. Glomerular filtration rate （including total and routine single renal GFR） were obtained. The extents of renal pathological lesions,including glomerular, tubulointerstitial and vessel lesion were semi-quantitatively scored with Katafuchi＇s criterion, and the scores were correlatively analyzed with GFR. Results With the increasing of pathological grade,the GFR gradually decreased with significant differences among all grades（P〈 0. 05 or P〈0. 01）. The GFR were negatively correlated with both glomerular lesion and tubulointerstitial lesion,as well as vascular lesion（P〈0. 05 or P〈0. 01）. The GFR were also negatively correlated with Scr and proteinuria and blood pressure including SBP and DBP. （P〈0. 05 or P〈0. 01）. Conclusions The renal dynamic imaging with ^99mTc-DTPA is promising in the disease monitoring and prognosis predicting of IgAN.

关 键 词：IGA肾病 肾功能不全 慢性 肾动态显像 

分 类 号：R692.04[医药卫生—泌尿科学] R586[医药卫生—外科学]