留存肾肾小球滤过率代偿情况及影响因素分析  

Reference values for glomerular filtration rate in patients with solitary kidney and multifactor analy- sis

作　　者：崔静[1] 任振泰[2] 武新宇[1] 高永举[1] 

机构地区：[1]郑州大学人民医院、河南省人民医院核医学科,450003 [2]郑州大学第五附属医院放疗科,450052

出　　处：《中华核医学与分子影像杂志》2016年第1期59-62,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：2013国家临床重点专科建设项目

摘　　要：目的建立一侧肾无功能或缺失、对侧肾功能代偿患者^99Tc^m-DTPA肾动态显像GFR代偿值的参考值范围，并探讨影响代偿的因素。方法回顾性分析2011年1月至2015年9月间108例[男62例，女46例，年龄5～83（47±19）岁]单侧肾功能正常而对侧肾缺如、无功能患者的^99Tc^m-DTPA肾动态显像结果，建立其单侧肾脏功能完全代偿后GFR参考值范围。分析年龄、性别、留存肾位置、患肾切除与否、不同病因等对留存。肾代偿能力的影响。采用两样本t检验、单因素方差分析和Bonferroni法分析数据。结果108例患者留存肾代偿后GFR为（71．81±23．23）ml／min。患者性别（t=0．496）、留存肾位置（t=0．999）、患肾切除与否（t=-1．966）及不同病因（F=1．894）对于留存肾GFR代偿情况影响无统计学意义（均P〉0．05）。不同年龄组间留存肾代偿后的GFR差异有统计学意义（F=13．924，P〈0．001）。留存肾GFR与年龄呈负相关（r=-0．570，P〈0．001）。4个年龄组（≤20岁、20岁〈年龄≤40岁、40岁〈年龄≤60岁、〉60岁）GFR的CV分别为37．6％、26．7％、21．3％和30．1％，≤20岁组CV明显大于其他3组。结论建立留存肾代偿后的GFR参考范围，可更为准确、客观地评价留存肾GFR。年龄与留存肾GFR代偿能力相关．年龄较小的患者代偿能力个体差异较大。Objective To establish the GFR reference range of solitary kidney by 99Tcm-DTPA SPECT imaging and explore factors influencing renal compensation. Methods A total of 108 patients （62 males, 46 females, age range： 5-83 （47±19） years） with only one functional kidney who underwent ^99Tc^m- DTPA dynamic imaging from January 2011 to September 2015 were retrospectively analyzed. The GFR was measured to establish the reference range. Meanwhile, the potential influence factors were analyzed, including age, gender, location of the functional kidney, removal and causes of the non-functional kidney. Twosample t test, one-way analysis of variance and Bonferroni test were used. Results The GFR were （71.81± 23.23） ml/min in the 108 patients. There were no significant differences of GFR between male and female patients （t = 0.496）, between patients with left functional kidney and those with right functional kidney（t = 0.999）, between patients with and without removed non-function kidney （t =- 1.966）, and among patients with different causes of the non-function kidney（ F= 1.894; all P〉0.05）. The GFR was significant different in different groups based on age（ F= 13.924, P〈0.001 ）. There was a negative correlation between the GFR and age （r =-0.570, P〈0.001 ）. The GFR CV in different age groups （ ≤ 20 years, 20 years 〈age ≤40 years, 40 years 〈age ≤ 60 years, and 〉60 years） were 37.6%, 26.7%, 21.3%, 30.1%, respectively. Conclusions It is objective and efficient to assess the renal compensation by establishing the reference values for GFR of the solitary kidney. There is a negative correlation between age and renal compensation, and the variation of renal compensation is larger in younger patients.

关 键 词：肾小球滤过率 代偿 放射性核素显像 DTPA 

分 类 号：R692[医药卫生—泌尿科学]