^(99m)Tc-DMSA肾静态显像对上尿路感染诊断的评价  

The evaluation of 99m Tc DMSA renal static scans in the diagnosis of upper urinary tract infection

作　　者：殷蕾[1] 盛芳芸[2] 曾纪骅[2] 吕红 

机构地区：[1]上海医科大学儿科医院 [2]上海医科大学儿科医院200127

出　　处：《中华儿科杂志》1999年第10期610-613,共4页Chinese Journal of Pediatrics

摘　　要：目的　评价９９ｍＴｃＤＭＳＡ 肾静态显像对上尿路感染的诊断价值。方法　对３０ 例发热（体温≥３８－５℃）、尿培养阳性的尿路感染患儿进行９９ｍＴｃＤＭＳＡ肾静态显像检查，并与泌尿系统Ｂ超检查结果和尿视黄醇结合蛋白与肌酐测定比值（ＲＢＰ／Ｃｒ） 进行对比分析。结果　９９ｍＴｃＤＭＳＡ显示３０ 例患儿中２７ 例（９０％） 有肾脏损害，其中２４ 例呈急性肾盂肾炎改变，３ 例有肾疤痕形成；３ 例正常。２ 岁以内的患儿肾脏病变范围比大于２ 岁的患儿广泛，程度更严重。通过Ｂ 超发现有肾脏损害的为５／２２（２３ ％） ；有尿ＲＢＰ／Ｃｒ 升高的为１１／２５（４４％ ） ，其中２ 例９９ｍＴｃＤＭＳＡ正常。结论　９９ｍＴｃＤＭＳＡ 肾静态显像对上尿路感染的定位、病变范围、程度、性质等的诊断有临床应用价值。Objective To evaluate techmetium 99m labled dimercaptosuccinic acid ( 99m Tc DMSA) renal static scan in the diagnosis of upper urinary tract infection (UUTI) Methods A prospective study of 30 children with acute febrile UUTI (T≥38 5℃) and positive urine cultures were carried out by using the technique of 99m Tc DMSA scan The results were analyzed and compared with the findings of ultrasonography and urine retinol binding protein/creatine(RBP/Cr) determination Results 99m Tc DMSA scan showed 90% (27/30) of the children with renal damages, 24 children with acute pyelonephritis (manifesting as a single or multiple areas of varying degrees of diminished cortical uptake of 99m Tc DMSA with or without bulging contour), 3 children with renal scarring (manifesting as cortical thinning flattening of the renal contour, or a wedge shaped defect), and 3 normal children Renal damages demonstrated by 99m Tc DMSA scan were more diffuse and dominant in children under 2 years than over 2 years Ultrasonography showed abnormalities of urinary system in 36% (8/22) of children, and renal damages in 23%(5/22) Urine RBP/Cr increased in 44% (11/25) of children, of whom two children showed normal 99m Tc DMSA scans Conclusion 99m Tc DMSA renal static scan is valuable in the diagnosis of UUTI It can be used to determine the extension, degree and nature of UUTI, and might guide the treatment and follow up observation in children with UUTI 99m Tc DMSA scan was thought particularly valuable in the diagnosis of infants with fever but without symptoms of urinary system The determination of urine RBP/Cr might serve as a complementary index of 99m Tc DMSA scan in the diagnosis of UUTI

关 键 词：肾 放射性核素显像 泌尿道感染 诊断 

分 类 号：R691.304[医药卫生—泌尿科学] R817.47[医药卫生—外科学]