肾综合征出血热多尿期肾图的变化及意义  

The Changes and Significance of Radionuclide Examination of Renography in Polyuric Stage of Hemorrhagic Fever with Renal Syndrome

作　　者：章莉莉[1] 孙志坚[1] 张东军[2] 戎云清 

机构地区：[1]南京医科大学第一附院感染科,江苏南京210029 [2]丹阳市人民医院传染病科,江苏丹阳212300

出　　处：《南京医科大学学报（自然科学版）》2001年第1期21-23,共3页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的 :研究肾综合征出血热 (HFRS)多尿期肾图的变化及其意义。方法 :静脉注射 1 31 I-邻碘马尿酸钠 (1 31 I- OIH) 3.7×10 9Bq(10 μCi) ,用闪烁照相法描记 15 min,通过电子计算机自动处理 ,得出肾图的各项参数。结果 :2 0例受检者均已进入多尿期 ,2 4h尿量在 2 0 0 0 ml以上 ,血尿素氮 (BUN)已正常或接近正常 ,但肾图却明显异常 ,表现为半排时间 (TC1 /2 )延长 (>8min) ,15min残留率 (C1 5 /b)超过 5 0 % ,肾脏指数大多低于 45 % ;同期作尿β2 -微球蛋白 (β2 - m )测定 ,也明显高于正常 ;8例作发射型电子计算机扫描 (ECT)检查 ,肾小球滤过率 (GFR)和有效肾血浆流量 (ERPF)分别为 (4 0 .8± 2 1.2 ) ml/min和 (35 0 .8± 10 2 .1) ml/min,均明显低于正常 (P<0 .0 1)。结论 :HFRS患者多尿期肾图大多呈排出不良和功能受损的图形 ,表明该期肾功能以及肾血流量尚未恢复正常 ,对症治疗仍需继续。Objective:In order to study the changes and its significance of radionuclide examination of renography in hemorrhagic fever with renal syndrome(HFRS) during polyuric stage. Methods:After intravenous injection of 131 I OIH3.7×10 9 Bq(10 μCi), renogram of the 20 patients was traced by scintiphotography and all parameters of renogram was analyzed by computer.Results:All renograms of the 20 patients had apparent abnormalities, although they got into polyuric stage, their urinary output exceeded 2 000 ml/d, and blood urea nitrogen (BUN) was almost close on normal. The half excretion time (TC 1/2 ) and 15 min remnant rate (C 15/b ) were more than 8 min and 50% respectively, and renal index (RI) was less than 45%. Besides, urinary β 2 microglobulin (β 2 m) concentration, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were significantly abormal ( P <0.01). Conclusion:Most HFRS patients in polyuric stage had renal dysfunction in renogram, which suggested that renal function and renal blood flow during this stage had not yet come to normal, and symptomatic treatment was neceessary. [

关 键 词：肾综合征出血热 放射性肾图 多尿期肾图 

分 类 号：R512.8[医药卫生—内科学]