三种评估活体供肾者肾小球滤过率方法的对比研究  

Comparative Study of Three Methods in Evaluation of Living Kidney Donors' Glomerular Filtration Rate

作　　者：古志明 

机构地区：[1]海南省农垦总医院核医学科,海口570311

出　　处：《医学综述》2014年第5期956-958,共3页Medical Recapitulate

摘　　要：目的探讨活体供肾者肾小球滤过率(GFR)简单易行的评估方法。方法选择海南省农垦总医院2009年5月至2012年5月行供肾评估的54例健康亲属,均给予99Tcm-DTPA双血浆法、肾动态显像法、Cockcroft-Gault公式法(C-G公式)及简化肾脏改变饮食试验(MORD)公式法评估其GFR,所得结果采用体表面积进行标准化,以双血浆法为参照标准评价以上三种肾功能评估方法的临床适用性、可靠性及准确性。结果四种评估方法的结果经比较,差异有统计学意义(F=14.17,P<0.05);肾动态显像法及简化MDRD公式法与双血浆法比较,差异均无统计学意义(P>0.05),C-G公式法与双血浆法比较,差异有统计学意义(P<0.05)。结论核素肾动态显像与简化MDRD公式联合使用,可更好、准确地评估供肾GFR,为临床工作提供真实可靠依据。Objective To explore a simple,effective and accurate method for evaluation of living kidney donors＇ glomerular filtration rate（GFR）.Methods A total of 54 living kidney donorsin Hainan Nongken General Hospital during May 2009 and May 2012 were selected, and their GFR was estimated with the methods of ^99Tc^m-DTPA,renal dynamic scintigraphy,Cockcroft-Gault equation（C-G equation） and simplified modification of diet in renal disease（MDRD） equation.the results were standardized by body surface area,and the clinical applicability,reliability and accuracy of the above three estimation methods were assessed using dual plasma sample method as reference.Results There were differences between the four methods（F=14.17,P〈0.05） in evaluation of GFR.Compared with dual plasma sample measurement,dynamic renal scintigraphy and MDRD had no significant differences（P〉0.05）.While C-G equation compared with dual plasma sample measurement had significant difference（P〈0.05）.Conclusion The method of dynamic renal scintigraphy combined with the simplified MDRD formula can provide accurate and reliable assessment for renal GFR in clinical.

关 键 词：活体供肾 肾小球率过滤 核素肾动态显像法 评估方程 

分 类 号：R817.4[医药卫生—影像医学与核医学] R692.5[医药卫生—放射医学]