螺旋CT多期增强扫描测定肾小球滤过率的临床分析  

Clinical analysis of spiral CT multi-phase enhancement scan in detection of glomerular filtration rate

作　　者：江建昌 罗庆华[1] 李彦伟[1] 邓宇[1] 

机构地区：[1]广州市花都区妇幼保健院(胡忠医院),510800

出　　处：《中国实用医药》2017年第17期73-74,共2页China Practical Medicine

基　　金：广州市花都区科技局(项目编号:15-HDWS-014)

摘　　要：目的本次研究主要是为了分析螺旋CT多期增强扫描测定肾小球滤过率(GFR)的临床效果。方法 20例无急性肾功能障碍的成年患者为研究对象,对患者进行CT检查,其中CT检查主要包括腹部平扫以及多期增强扫描,并对患者使用碘海醇对比剂,注射总量为90 ml,注射时的速率保持在3 ml/s。此外,再使用Patlak方程测量组织和血液内的示踪剂浓度,以此来计算出该组织摄取示踪剂的速度常量,从而计算GFR。此外,还需要使用单光子发射计算机断层成像术(SPECT)对患者的GFR进行检测。结果通过研究之后发现,研究对象在CT的检测之下,其左肾GFR为(64.36±5.38)ml/(min·1.73 m^2),右肾GFR为(65.72±5.37)ml/(min·1.73 m^2),总肾GFR为(129.48±10.49)ml/(min·1.73 m^2),而使用SPECT所测得的左肾GFR为(41.74±5.49)ml/(min·1.73 m^2),右肾GFR为(43.36±6.31)ml/(min·1.73 m^2),总肾GFR为(85.09±10.73)ml/(min·1.73 m^2)。通过对两组进行相关性分析之后发现,这两组GFR测定法之间的相关性较好,左肾、右肾、总肾GFR两种方法相关系数r=0.877、0.877、0.867(P<0.01)。结论螺旋CT多期增强扫描能够准确的测定肾小球滤过率,具有一定临床价值,值得推广使用。Objective To analyze clinical effect by spiral CT multi-phase enhancement scan in detection of glomerular filtration rate （GFR）. Methods A total of 20 adult patients without acute renal dysfunction as study subjects all received CT examination, including abdominal plain scan and multi-phase enhancement scan. The patients received 90 ml iohexol contrast agent by 3 ml/s in injection. Patlak equation was applied to detect concentration of tracer agent in tissue and blood, in order to calculate GFR in patients by calculating constant velocity of tracer agent accumulation. Single photon emission computed tomography （SPECT） was used to detect GFR in patients. Results CT examination showed left kidney GFR as （64.36 ± 5.38） ml/（min ·1.73 m^2）, right kidney GFR as （65.72 ± 5.37） ml/（min·1.73 m^2）, and total kidney GFR as （129.48 ± 10.49） ml/（min·1.73 m^2）. SPECT examination showed left kidney GFR as （41.74 ± 5.49） ml/（min·1.73 m^2）, right kidney GFR as （43.36 ± 6.31） ml/（min·1.73 m^2）, and total kidney GFR as （85.09 ± 10.73） ml/（min ·1.73 m^2）. Correlation analysis in the two groups showed excellent correlation between the two detection measures, with correlation coefficient r=0.877, 0.877, 0.867 in left kidney GFR, right kidney GFR and total kidney GFR （P〈0.01）. Conclusion Spiral CT multi-phase enhancement scan can provide acute detection of glomerular filtration rate, along with certain clinical value. This method is worth promoting and applying.

关 键 词：多起增强扫描 肾小球 滤过率 临床分析 

分 类 号：R692[医药卫生—泌尿科学]