核素肾动态显像对2型糖尿病患者肾功能的研究  

Radionuclide renal dynamic imaging for renal function study in patients with type 2 diabetes mellitus

作　　者：张遵城[1] 郑妙瑢[1] 董萍[1] 李小东[1] 孙慧东[1] 王芬[1] 

机构地区：[1]天津医科大学第二医院核医学科,300211

出　　处：《中华内分泌代谢杂志》2000年第6期363-365,共3页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的　了解不同阶段 2型糖尿病 (DM)患者肾脏血流动力学的变化及肾功能受损情况。方法　将 5 7例 2型DM患者根据尿白蛋白排泄率 (UAER)分为三组 :(1)DM正常白蛋白尿组 (DM1组 ) 11例 ,UAER <2 0 μg/min。 (2 )DM微量白蛋白尿组 (DM 2组 ) 2 6例 ,UAER :2 0～ 2 0 0 μg/min。(3)DM临床蛋白尿组 (DM 3组 ) 2 0例 ,UAER >2 0 0 μg/min。与 2 0例正常对照组 (NC)一起进行99mTc 二乙三胺五乙酸 (99mTc DTPA)和99mTc 双半胱氨酸 (99mTc EC)肾动态显像。结果　DM 1组肾小球滤过率 (GFR)及肾有效血浆流量 (ERPF)明显高于NC组 (P <0 .0 1)。DM2组GFR、ERPF与NC组相比无差异 ,但其99mTc DTPA法测定的肾功能曲线半排时间 (T1/2 )延长 (P <0 .0 5 ) ,2 0分钟残留率 (C2 0 )增高 (P <0 .0 5 )。DM 3组GFR、ERPF明显下降 (P <0 .0 1) ,肾功能曲线峰时 (Tp)后延 (P<0 .0 1) ,T1/2 更加延长 (P <0 .0 1) ,C2 0 更加增高 (P <0 .0 1)。结论　核素肾动态显像可早期诊断 2型DM ,并了解肾功能受损程度 ,DN的进程以及为临床治疗和随访提供了依据。Objective To detect the changes of renal hemodynamics, radionuclide renal dynamic imagings were performed in patients with type 2 diabetes millitus (DM) in different stage. Methods Fifty seven patients with type 2 DM were divided into 3 groups according to the value of urinary albumin excretion rate (UAER). (1)GroupDM1:UAER<20μg/min,11cases.(2)Group DM2: UAER 20～200 μg/min, 26 cases. (3)Group DM3:UAER>200 μg/min, 20 cases. 99m Tc DTPA and 99m Tc EC renal dynamic imagings were performed in the type 2 DM patients of 3 groups and 20 normal controls (NC). Glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and renogramweregainedsimultaneously.Results GFR and ERPF were significantly increased in group DM1 than those in NC (P<0.01). In group DM2 DGFR and ERPF were not significantly different from NC, but the half activity time (T 1/2 ) of the renogram significantly prolonged (P<0.05), the 20 minutes retention rate (C 20 ) of the renogram in 99m Tc DTPA method significantly increased (P<0.05) compared with NC. In group DM3 GFR and ERPF were remarkably decreased (P<0.01), and the peaktime (T p) of the renogram delayed (P<0.01), T 1/2 and C 20 were more distinctly prolonged and increased respectively (P<0.01) as compared with NC. Conclusion Radionuclide renal dynamic imaging is helpful for the judgement of renal damage in early stage of DM and the extent of the damage in different DN stage. It also provides the evidences for further treatment and evaluation of prognosis in patients with type 2 DM.

关 键 词：糖尿病 非胰岛素依赖型 放射性核素显像 肾功能 

分 类 号：R817.4[医药卫生—影像医学与核医学]