^(99m)Tc-DTPA肾小球滤过率测定评估肿瘤患者化疗后肾功能损伤的价值  

Value of ^(99m)Tc-DTPA GFR determination in evaluating renal injury in cancer patients after chemotherapy

作　　者：谭维琴[1] 崔建和[1] 杨士军[1] 

机构地区：[1]南京医科大学附属淮安第一医院核医学科,江苏省223300

出　　处：《江苏医药》2013年第1期83-85,共3页Jiangsu Medical Journal

摘　　要：目的探讨99m锝-亚锡喷替酸(99mTc-DTPA)肾小球滤过率(GFR)测定评估肿瘤患者化疗后肾功能损伤的价值。方法肿瘤患者化疗后行单光子发射型计算机断层仪(SPECT)全身骨显像肾脏过度显影的63例,行GFR及血清尿素氮(BUN)、肌酐(SCr)和B2-微球蛋白(B2-MG)测定。按GFR水平分轻度降低组(15例,GFR 80-50ml/min)、中度降低组(31例,GFR 50-30ml/min)和重度降低组(17例,GFR<30ml/min)。对照组20例为未化疗的全身骨显像肾脏显影正常的肿瘤患者。比较四组血清BUN、SCr及B2-MG差异。结果 63例患者GFR均低于对照组。GFR中度降低时,血清B2-MG高于对照组(P<0.01)。GFR重度降低时,血清BUN及B2-MG均高于其他三组(P<0.01)。结论 99mTc-DTPA GFR测定对诊断肿瘤化疗后的早期肾损伤较血清BUN、SCr及B2-MG灵敏。Objective To explore the value of ^99mmTc-DTPA glomerular filtration rate（GFR） determination in evaluating the renal injury of cancer patients after chemotherapy. Methods GFR detected by SPECT was determined with ^99mmTc-DTPA in sixty-three cancer patients underwent chemotherapy and with over-development on SPECT imaging. Serum urea nitrogen（BUN）, creatinine （SCr） and B2-microglobulin （B2-MG） were examined. On the basis of GFR values, the patients were divided into three groups of A（15 cases,GFR 80-50 ml/min）, B（31 cases, GFR 50-30 ml/min） and C （17 cases,GFR （30 ml/min）. Twenty cancer patients without chemotherapy and with normal renal SPECT immage were taken as the controls （group D）. The differences of serum BUN, SCr and B2-MG were analyzed among 4 groups. Results GFR was lower in groups of A,B and C than that in group D. Serum B2-MG was higher in group B than that in group D（P〈0. 01）. Serum BUN and B2-MG were higher in group C than those in groups of A, 13 and D（P〈0. 01）. Conclusion Compared to serum BUN, SCr and B2-MG examination, ^99mm Tc-DTPA GFR determination is more sensitive in the early diagnosis of renal injury in cancer patients after chemotherapy.

关 键 词：肾小球率过滤 肌酐 尿素氮 B2-微球蛋白 99m锝-亚锡喷替酸 

分 类 号：R817[医药卫生—影像医学与核医学]