非离子型造影剂iohexol血浆清除率单点检测法测定肾小球滤过率  

Determination of glomerular filtration rate by non-ionic contrast medium iohexol plasma clearance

作　　者：史浩[1] 陈楠[1] 陈晓农[1] 王伟铭[1] 张文[1] 徐耀文[1] 任红[1] 何新英[1] 

机构地区：[1]上海第二医科大学附属瑞金医院肾内科,200025

出　　处：《中华肾脏病杂志》2002年第4期239-242,共4页Chinese Journal of Nephrology

摘　　要：目的 用非离子型造影剂iohexol血浆清除率检测肾小球滤过率(GFR)。方法 选择93例各种肾脏病患者,男45例,女48例,年龄12-80岁,清晨空腹注射iohexol 5ml,4 h后留取血样,高效液相(HPLC)法检测血浆iohexol浓度,应用Jacobsson和Bubeck两种一室分布的数学模型,计算iohexol血浆清除率,以99mTc-GFR作为检测GFR的金标准,对两者进行比较。结果 Jacobsson法算得iohexol-GFR与99mTc-GFR相关系数为r=0.85,标准误为16.06 ml/min;Bubeck法算得iohexol-GFR与99mTc-GFR相关系数为r=0.82,标准误为17.75 ml/min。在早期肾功能不全的患者中,iohexol-GFR较Scr、Ccr能更敏感反映肾功能减退。结论 应用Jacobsson和Bubeck两种模型单点法计算iohexol血浆清除率是检测GFR的简便、准确的方法。Objective To evaluate the determination of glomerular filtration rate (GFR) by non-ionic contrast medium iohexol plasma clearance. Methods GFR of 93 patients, 45 male and 48 female, age ranged from 12 to 80, with different renal functions was determined. The patient underwent an overnight fast and 5 ml of iohexol was injected into peripheral vein in the morning. 2 ml plasma sample was collected 4 hours after injection, and plasma concentration of iohexol was measured by high performance liquid chromatography(HPLC) . The iohexol plasma clearance was calculated by two one-compartment model; Jacobsson's and Bubeck's model. 99mTc clearance was used as the reference method. Results Iohexol-GFR obtained by Jacobsson's model vs 99mTc-GFR yielded a correlation of r = 0. 85, standard error of the estimate (SE) = 16. 06 ml/min. There was also a high correlation between iohexol-GFR obtained by Bubeck's model and 99mTc-GFR, r = 0. 82, SE = 17. 75 ml/min. In the patients in early stage of renal failure, iohexol-GFR was the most sensitive indication as compared to Scr and Ccr. Conclusion Iohexol plasma clearance calculated by Jacobsson's and Bubeck's models is a simple and accurate method of determining GFR.

关 键 词：非离子型造影剂 IOHEXOL 血浆清除率 单点检测法 肾小球滤过率 高效液相 肾脏疾病 

分 类 号：R692.04[医药卫生—泌尿科学]