轻中度肾功能损伤成人患者核素测定肾小球滤过率的对比研究  

Comparative study of GFR isotopic measurement in adult patients with mild-to-moderate renal impairment

作　　者：陈卓 罗高潮 叶佳 张平[1] Chen Zhuo;Luo Gaochao;Ye Jia;Zhang Ping(Department of Nuclear Medicine,Huanggang Central Hospital of Yangtze University,Huanggang 438000,China)

机构地区：[1]长江大学附属黄冈市中心医院核医学科,黄冈438000

出　　处：《国际放射医学核医学杂志》2024年第8期491-495,共5页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨^(99)Tc^(m)-二亚乙基三胺五乙酸(DTPA)核素肾动态显像及其双血浆法测定肾小球滤过率(GFR)在轻中度肾功能损伤患者中的评估价值。方法回顾性分析2019年1月至2022年12月黄冈市中心医院收治的87例轻中度肾损伤成人患者,其中男性49例、女性38例,年龄(45.56±11.29)岁。所有患者均行^(99)Tc^(m)-DTPA肾动态显像获得校正后Gate's法测定GFR(记为gGFR),同时行经校正后的2 h和4 h单血浆法,以及双血浆法测定双肾GFR,分别记为GFR 2h、GFR 4h、dGFR。依据双肾dGFR将患者分为轻度[60 ml/(min·1.73 m^(2))≤dGFR<90 ml/(min·1.73 m^(2))]52例和中度[30 ml/(min·1.73 m^(2))≤dGFR<60 ml/(min·1.73 m^(2))]35例2组。组内和组间的比较采用配对t检验,2种方法间的相关性分析采用Pearson相关性分析。结果轻度组52例患者中,与dGFR[(72.33±7.12)ml/(min·1.73 m^(2))]比较,gGFR[(78.92±19.56)ml/(min·1.73 m^(2))]、GFR 2h[(38.87±4.14)ml/(min·1.73 m^(2))]、GFR 4h[(65.69±4.95)ml/(min·1.73 m^(2))]的差异均有统计学意义(t=-2.84、50.55、20.64,均P<0.05);相关性r值分别为0.55、0.76、0.99。中度组35例患者中,与dGFR[(46.73±8.42)ml/(min·1.73 m^(2))]比较,gGFR[(55.71±15.80)ml/(min·1.73 m^(2))]、GFR 2h[(26.68±8.15)ml/(min·1.73 m^(2))]、GFR 4h[(45.47±7.70)ml/(min·1.73 m^(2))]的差异均有统计学意义(t=-3.91、21.67、3.37,均P<0.05);相关性r值分别为0.51、0.76、0.97。结论轻中度肾功能损伤患者核素GFR测定可获得较好的临床评估价值,其中4 h单血浆法测定GFR较为合适。推荐结合4 h采样单血浆法和肾动态显像肾图评价双肾及分肾功能。ObjectiveTo evaluate the utility of glomerular filtration rate(GFR)values derived from ^(99)Tc^(m)-diethyleue-triaminepentaacetic acid(DTPA)radionuclide renal dynamic imaging and dual plasma method in patients with mild-to-moderate renal impairment.MethodsA retrospective analysis was conducted on 87 adult patients(49 males and 38 females with an average age of 45.56±11.29 years)with mild-to-moderate renal dysfunction registered in the Nuclear Medicine Department of Huanggang Central Hospital from January 2019 to December 2022.All the patients underwent ^(99)Tc^(m)-DTPA renal dynamic imaging,and their GFRs were determined using the Gate's method and recorded as gGFR after correction.Blood samples at 2 h and 4 h were collected for each patient.Their GFRs were then calculated using single-and dual-plasma sampling methods and denoted as GFR 2h,GFR 4h,and dGFR.The patients were divided into two groups:52 cases with mild(60 ml/(min·1.73 m^(2))≤dGFR<90 ml/(min·1.73 m^(2)))and 35 cases with moderate(30 ml/(min·1.73 m^(2))≤dGFR<60 ml/(min·1.73 m^(2)))groups according to their dGFR.Within-group and between-group comparisons were performed using paired t-tests.The correlation between the two methods was analyzed with Pearson correlation analysis.ResultsFor the 52 patients in the mild group,the dGFR((72.33±7.12)ml/(min·1.73 m^(2)))significantly differed from the gGFR((78.92±19.56)ml/(min·1.73 m^(2))),GFR 2h((38.87±4.14)ml/(min·1.73 m^(2))),and GFR 4h((65.69±4.95)ml/(min·1.73 m^(2)))(t=-2.84,50.55,20.64;P<0.05)with correlation r values of 0.55,0.76,and 0.99,respectively.For the 35 patients in the moderate group,the dGFR((46.73±8.42)ml/(min·1.73 m^(2)))significantly differed from the gGFR((55.71±15.80)ml/(min·1.73 m^(2))),GFR 2h((26.68±8.15)ml/(min·1.73 m^(2))),and GFR 4h((45.47±7.70)ml/(min·1.73 m^(2)))(t=-3.91,21.67,3.37;P<0.05)with correlation r values of 0.51,0.76,and 0.97,respectively.ConclusionsGFR measurement using the radionuclide method is valuable in the diagnosis of patients with mild-to-mod

关 键 词：肾小球滤过率 99M锝五乙酸盐 肾动态显像 体层摄影术 发射型计算机 单光子 Gate's法 血浆分析法 

分 类 号：R692[医药卫生—泌尿科学] R817.4[医药卫生—外科学]