核素肾动态显像对老年非胰岛素依赖型糖尿病患者肾功能的研究  

Radionuclide dynamic renal imaging for renal function study in the elderly with NIDDM

作　　者：杨瑞品[1] 屈婉莹[1] 薛翠英[1] 迟家敏[1] 孙美珍[1] 

机构地区：[1]卫生部北京医院核医学科

出　　处：《中华老年医学杂志》1997年第4期206-208,共3页Chinese Journal of Geriatrics

摘　　要：目的旨在评价非胰岛素依赖型糖尿病（ＮＩＤＤＭ）老年患者糖尿病肾病（ＤＮ）的进程，为临床治疗和判断预后提供依据。方法以９９ｍＴｃ－ＤＴＰＡ为示踪剂进行肾动态显像，同时获得肾小球滤过率（ＧＦＲ）、肾功能曲线和肾动态显像。结果本组患者ＧＦＲ均降低，病程≤１０年（６５．３±１３．１ｍｌ／ｍｉｎ）和病程＞１０年（５４．２±１５．７ｍｌ／ｍｉｎ）较对照组（９０．４±１６．６ｍｌ／ｍｉｎ）明显降低（Ｐ＜０．０１）；肾功能曲线峰时，病程≤１０年（左右肾分别为４．４±１．５及４．４±１．４分）和病程＞１０年（４．５±１．８及４．６±１．７分）较对照组（均为３．６±０．９分）明显后延（Ｐ＜０．０１），１０和２０分钟残存率均增高，后者仅病程＞１０年（左右肾分别为５４．２％±１４．１％及５３．９％±１４．２％）者较对照组（４８．６％±８．３％及４８．２％±９．３％）明显增高（Ｐ＜０．０５）。结论本组糖尿病患者的肾脏滤过和排泌功能均受损，其程度随ＮＩＤＤＭ病程的延长而加重，提示病程已进入ＤＮⅡ～Ⅳ期。Objective To evaluate the advance of diabetic nephropathy (DN)in the elderly with non insulin dependent diabetes mellitus(NIDDM)by radionuclide dynamic renal imaging. Methods Dynamic renal imaging was performed with 99m Tc DTPA in 67 NIDDM elderly and 36 normal elderly controls (NC). Glomerular filtration rate (GFR), renogram and kidney imaging were obtained simultaneously. Results GFR decreased in the diabetics. The decrease of GFR became larger with longer duration of NIDDM and difference was remarkably significant in comparison with NC( P <0 01).Peaktime of renogram delayed more distinctly in all diabetics than that in NC( P <0 01). Residual rate at 10 and 20 min increased, the increasing level was especially higher in the diabetics over 10 years duration than that in NC( P <0 05). Conclusions The function of glomerular filtration and tubular secretion was damaged in the diabetics and became worse with advancing duration of NIDDM. This study suggests that DN developed belongs to stages Ⅱ Ⅳ.

关 键 词：糖尿病 非胰岛素依赖型 肾功能 

分 类 号：R587.205[医药卫生—内分泌]