346例上尿路结石患者99Tcm-DTPA肾动态显像结果分析

Analyses of 99Tcm-DTPA dynamic kidney imaging on 346 patients of upper urinary tract calculi

  • 摘要:
    目的 探讨99Tcm-二亚乙基三胺五乙酸(99Tcm-DTPA)肾动态显像在上尿路结石患者肾功能评价中的临床价值。
    方法 回顾性分析了346例上尿路结石患者的核素肾动态显像、静脉肾盂造影(IVP)和血尿素氮(BUN)、血清肌酐(SCr)值,并依据总肾肾小球滤过率(GFR)将BUN和SCr结果分成4组进行分析。
    结果 ① 346例肾动态显像患者,总肾GFR与BUN、SCr水平呈明显负相关(r=-0.458,P=0.000;r=-0.542,P=0.000)。② 4组之间比较,BUN和SCr均存在统计学差异(F=49.23,P=0.000;F=80.66,P=0.000);经最小显著差别法分析,组1与组2之间比较,BUN和SCr均无统计学差异(P=0.119和P=0.088);而其余各组之间比较,BUN和SCr均存在统计学差异(P均 < 0.05)。③ IVP不显影的43只患肾中,经99Tcm-DTPA肾动态显像提示有18只(41.9%)有残余肾功能(GFR≥10 ml/min),平均GFR为(21.89±12.81)ml/min。
    结论 99Tcm-DTPA肾动态显像能早期评价肾功能,特别是对IVP不显影的患肾功能的评价具有重要临床价值。

     

    Abstract:
    Objective To explore the clinical value of 99Tcm-DTPA renal dynamic imaging in evaluating renal function of the patients with upper urinary tract calculi.
    Methods The results of 99Tcm-DTPA renal dynamic imaging,glomerular filtration rate(GFR),intravenous pyelography(IVP),blood urea nitrogen(BUN)and serum creatinine(SCr)in 346 patients with upper urinary tract calculi diseases were analyzed retrospectively. These 346 patients were divided into four groups according to their total GFR value.
    Results ① The renal dynamic imaging in 346 patients could accurately reflect the function of the two kidneys. GFR was negatively related to the serum BUN and SCr levels(r=-0.458,P=0.000 and r=-0.542,P=0.000). ② The BUN and SCr levels showed significant difference among the four groups(F=49.23,P=0.000 and F=80.66,P=0.000). There were no significant difference of the BUN and SCr levels found between group 1 and group 2(P=0.119,P=0.088,respectively),while significant difference of the BUN and SCr levels found among the other groups (P < 0.05 for all situations). ③ Forty-three kidneys of the 346 patients were not visualized by IVP,while 18 of them(41.9%)had shown residual function(GFR≥10ml/min)with 99Tcm-DTPA renal dynamic imaging,the mean GFR was (21.89±12.81)ml/min.
    Conclusion 99Tcm-DTPA renal dynamic imaging is valuable to early evaluate the renal function,especially for the sick renal function in IVP detection failed patients.

     

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