^99Tc^m-DTPA肾动态显像对狼疮肾炎肾功能及病理损害的评估  

Evaluation of renal function and pathological changes in patients with lupus nephritis by ^99 Tc^m-DTPA renal dynamic imaging

作　　者：李现军[1] 李桂芝[2] 孙建梅 赵志华[1] 李凤岐[1] 李明[2] 

机构地区：[1]潍坊医学院附属潍坊市人民医院核医学科,261041 [2]潍坊医学院附属潍坊市人民医院免疫风湿科,261041 [3]潍坊市第二人民医院内科

出　　处：《中华核医学杂志》2010年第1期35-37,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨^99Tc^m-DTPA肾动态显像对狼疮肾炎（LN）患者肾功能损害的早期评价及评价结果与病理类型的关系。方法健康对照组10名，病理资料完整的LN患者29例，其中包括无症状LN（SLN）组18例，有症状LN（OLN）组11例。行^99Tc^m-DTPA肾动态显像，计算双肾的肾小球滤过率（GFR）、高峰时间（tp）、半排时间（t1/2）及20min排泄率（R20），由核医学科医师对肾功能是否受损及受损程度进行评估。统计学分析包括t检验、Fisher确切概率法分析和行×列表关联分析。结果SLN组及OLN组均较健康对照组出现tp延长（t=5．3，9．3，P均〈0．05），t1／2延长（t=6．9，12．0，P均〈0．05）及R20下降（t=10．1，12．1，P均〈0．05），OLN组出现GFR下降（t=4．1，P〈0．05），SLN组GFR下降不显著（t=1．7，P〉0．05）；经关联性分析，肾动态显像诊断肾损害的严重程度与病理分型相关（r=0．2273，P〈0．05）。结论全面分析^99Tc^m-DTPA肾动态显像可对系统性红斑狼疮患者进行早期肾功能评价，有效检出无。肾损害症状的LN患者，并为无条件行。肾活组织检查的LN患者病理损害评估提供帮助。Objective To analyze the relation between ^99Tc^m-DTPA renal dynamic imaging and pathological changes in patients with lupus nephritis （LN）. Methods Ten normal control and 29 patients with LN underwent ^99Tc^m-DTPA renal dynamic imaging. The LN patients were divided into two groups： silent LN （SLN） group, 18 patients; and obvious LN （OLN） group, 11 patients. For each case, glomerular filtration rate （GFR）, peak time （tp）, half excretion time （t1/2 ） and the excretion rate at 20 min （R20） were calculated. Assessment of renal function on the scintigraphic images was evaluated by nuclear medicine physicians. The t-test, Fisher＇ exact probability and R x C association were used for data analysis. Results There were significant differences between normal people and two groups of LN in tp （t = 5.3, 9.3, both P 〈 0. 05）, t2/2 （t = 6.9, 12.0, both P 〈 0.05） and R20 （t = 10.1, 12.1, both P 〈 0. 05）. As to GFR, there was significant decrease in OLN patients （ t = 4. 1, P 〈 0.05 ）, but not in SLN patients （ t = 1.7, P 〉 0.05）. Diagnoses of renal function by renal dynamic imaging were compared with the renal pathological changes （ r = 0. 2273, P 〈 0.05 ）. Conclusions ^99 Tc^m-DTPA renal dynamic imaging is useful for evaluation of the early stage renal function for LN patients and to diagnose LN patients with no symptom of renal impairment. It may help to assess the degree of renal parenchymal damage while obviating the need for renal biopsy in these patients.

关 键 词：狼疮肾炎 放射性核素显像 DTPA 

分 类 号：R817.4[医药卫生—影像医学与核医学] R593.242[医药卫生—放射医学]