南方医科大学学报2016，Vol.36Issue(7)：1021-1023,3.DOI:10.3969/j.issn.1673-4254.2016.07.27
静脉肾盂造影示无功能肾患者的肾功能状态评估
Dynamic renal scintigraphy versus dual-plasma sample clearance for determining glomerular filtration rates in patients with nonfunctioning kidneys shown by intravenous pyelography
摘要
Abstract
Objective To study the actual glomerular filtration rates (GFR) in patients with nonfunctioning kidneys as shown by intravenous pyelography (IVP) using single photon emission computed tomography (SPECT) dynamic renal scintigraphy and dual-plasma sample clearance method. Methods We retrospectively analyzed 107 patients with nonfunctioning kidneys shown by IVP who underwent renal dynamic 9 Tcm-DTPA SPECT imaging. GFR was measured by Gates' methods (GFRGates') and dual-plasma sample clearance method (GFRdual-plasma). Based on the dynamic functional images and GFRdual-plasma measurements, the patients were categorized into mild renal impairment (GFRdual-plasma≥30 mL/min), moderate renal impairment group (GFRdual-plasma of 20-30 mL/min), severe renal impairment group (GFRdual-plasma of 10 to 20 mL/min), and nonfunctioning kidney group (GFRdual-plasma≤10 mL/min), and GFRGates' were compared among the groups. Results According to GFRdual-plasma, the numbers of patients having mild, moderate, and severe renal impairment and nonfunctioning kidneys were 12(11.2%), 33 (30.8%), 41(38.3%), and 21(19.6%), respectively. GFRdual-plasma and GFRGates' were not significantly different in mild and moderate renal impairment groups, but in patients with severe renal impairment, GFRdual-plasma was significantly lower than GFRGates' (13.9± 6.2 vs 18.8±4.2 mL/min;t=-2.73, P=0.03), which was also the case with patients with nonfunctinging kidneys (4.5±2.1 vs 7.2±3.2 ml/min;t=-3.81, P=0.005). Conclusion Of the patients with nonfunctinging kidneys shown by IVP, only 58%of them actually have severe renal impairment or worse, and further SPECT dynamic renal scintigraphy is necessary to assess the actual risk of renal function impairment before operation.关键词
肾动态显像/SPECT/静脉肾盂造影/双血浆法Key words
dynamic renal scintigraphy/single photon emission computed tomography/dual-plasma sample clearance/intra-venous pyelography引用本文复制引用
胡志辉,孙涛涛,王淑侠,朱林波..静脉肾盂造影示无功能肾患者的肾功能状态评估[J].南方医科大学学报,2016,36(7):1021-1023,3.基金项目
“十一五”国家科技计划（2007BAI05B01）Supported by National Key Technology R&D Program (2007BAI05B01) （2007BAI05B01）
