单光子发射计算机断层成像技术肾功能显像在早期糖尿病肾病诊断中的应用  

Single-photon emission computerized tomography for renal function imaging applied to diagnosis of early diabetic nephropathy

作　　者：林敏[1] 朱柳君[1] 莫春香 黄忠道[1] 

机构地区：[1]广西柳州市柳铁中心医院,柳州市545007

出　　处：《广西医学》2017年第12期1855-1857,共3页Guangxi Medical Journal

摘　　要：目的探讨单光子发射计算机断层成像(SPECT)技术肾功能显像在早期糖尿病肾病诊断中的应用。方法回顾性分析对156例糖尿病患者的临床资料,根据尿微量白蛋白水平将糖尿病患者分为正常白蛋白组72例、微量白蛋白组48例、大量白蛋白组36例,同时选择20例健康体检者作为对照组。研究对象均接受采用SPECT仪行肾功能显像检查,比较4组肾小球滤过率(GFR)、血肌酐、尿白蛋白、尿β2微球蛋白水平及肾脏20 min残留率、肾脏半排时间。结果对照组、正常白蛋白组、微量白蛋白组、大量白蛋白组的GFR水平依次降低,而尿白蛋白水平依次升高(P<0.05);大量白蛋白组患者血肌酐及β2微球蛋白水平高于其他3组(P<0.05),但正常白蛋白组、微量白蛋白组与对照组比较差异无统计学意义(P>0.05);对照组、正常白蛋白组、微量白蛋白组、大量白蛋白组的肾脏20 min残留率依次降低,大量白蛋白组患者肾脏半排时间高于其他3组(P<0.05);GFR与尿白蛋白水平呈负相关(r=-0.251,P<0.05)。结论 SPECT肾功能显像能较为准确地反映糖尿病患者的肾功能状态,有助于早期发现糖尿病肾病患者。Objective To explore the application of single-photon emission computerized tomography（ SPECT） for renal function imaging to the diagnosis of early diabetic nephropathy. Methods The clinical data of 156 patients with diabetes mellitus were retrospectively analyzed. The diabetic patients were divided into normoalbuminuria group（ n = 72）,microalbuminuria group（ n = 48） and macroalbuminuria group（ n =36） according to their microalbuminuria levels,and 20 concurrent individuals underwent physical examination as control group. All subjects received renal function imaging using SPECT,and the glomerular filtration rate（ GFR）,the levels of serum creatinine（ SCr）,urine albumin and urine β2-microglobulin（ β2-MG）,and the 20-minute residual rate and half maximum time of kidney were compared among the four groups.Results The GFR levels decreased but the urine albumin levels increased in the order of the control group,the normoalbuminuria group,the microalbuminuria group and the macroalbuminuria group（ P〈0. 05）. The levels of SCr and β2-MG in the macroalbuminuria group were higher than those in the other three groups（ P〈0. 05）,but no statistically significant difference was found among the normoalbuminuria group,the microalbuminuria group and the control group（ P〈0. 05）. The kidney 20-minute residual rates decreased in the order of the control group,the normoalbuminuria group,the microalbuminuria group and the macroalbuminuria group,and the kidney half maximum time in the macroalbuminuria group was higher than those in the other three groups（ P〈0. 05）. GFR negatively correlated with the level of urine albumin（ r =-0. 251,P = 0. 016）. Conclusion SPECT for renal function imaging can accurately reflect the state of renal function in patients with diabetes mellitus,and might contribute to early diagnosis of diabetic nephropathy.

关 键 词：单光子发射计算机断层成像 肾功能显像 糖尿病 肾功能 

分 类 号：R587.1[医药卫生—内分泌]