摘要
Abstract
Objective The aim of this study was to assess clinical accuracy of GFR measurements assessed from gates methods of dynamic renal imaging by considering the 99mTc-DTPA-dual blood sample method as the reference in patients with different kidney diseases. Methods The study was performed in 202 patients between June 2009 and June 2010 with various degrees of renal function varied from normal to severely impaired [123 males and 79 females, age (49.5 ± 3.9) years old]. There were 398 kidneys. The GFR of each kidney was measured by gates and two-sample method. According to 99mTc-DTPA-dual blood sample method (dGFR). These patients were divided into 5 groups as follows: normal(≥40), 4(30～39.9), 3(20～29.9), 2(10～19.9), 1 ( < 10) [mL·min-1· (1.73 m2)-1]. Pearson correlation analysis was used between GFR from gates and dGFR in all groups. Bland-Altman plotting was also performed to define the 95% limits of agreement, which was presented as bias ± 1.96 s. Results There were 28 patients and 23 kidneys, 16 patients and 42 kidneys, 22 patients and 40 kidneys, 21 patients and 45 kidneys, 20 patients and 34 kidneys in normal, 4, 3, 2, 1 group respectively. (1) Pearson correlation analysis showed good correlation between gates and double-sample method (r = 0.722, P= 0.000) in total patients, the linear regression equation was gates = 16.708 + 0.505 dGFR. The same correlations were poor in 3, 4 and normal group (r = 0.341, P = 0.002, r = 0.368, P = 0.002 and r = 0.319, P = 0.004, respectively). The linear regression equation was respectively gates = -9.7 + 1.899 dGFR, gates = 31.671 + 0.060 dGFR and gates = 17.225 + 0.879 dGFR. There were no statically difference between group 1 and 2 (r = 0.038, P = 0.747 and r = 0.198, P= 0.077). (2)The concordance study using the Bland-Altman method showed that there was poor consistency between gates and dGFR in all groups. Conclusions Dynamic renal imaging was acceptable for estimating GFR, but better correct GFR was assessed by linear regression equation according to dGFR. However, double-sample method should be recommended for accurate determination of the GFR in group 1 and 2.关键词
肾小球滤过率/肾动态显像/双血浆法/99mTc-DTPAKey words
Glomerular filtration rate/ Dynamic renal imaging/ Double-sample method/ 99mTc-DTPA
