Objective To detect the changes and clinical influence elements of radionuclide renal dynamic imaging to measure glomerular filtration rate(GFR)and effective renal plasma flow(ERPF)in patients with type 2 diabetes mellitus(T2DM).

Methods One hundred and eight patients with T₂DM were divided into 4 groups according to the values of urinary albumin excretion rate(UAER): GroupⅠ: UAER < 20μg·min^－1, 31 cases.GroupⅡ: UAER 20~200μg·min^－1, 28 cases.GroupⅢ: UAER > 200μg·min^－1, serum creatinine(SCr) < 105μmol/L, 26 cases.GroupⅣ: UAER > 200μg·min^－1, SCr≥105μmol/L, 23 cases.⁹⁹Tc^m-diethylenetriamine pentaacetic acid and⁹⁹Tc^m-ethylenedicysteine renal dynamic imaging were performed in all patients.GFR, ERPF and renogram were derived simultaneously.The levels of blood creatinine, blood urea nitrogen, urine albumin, blood press, fasting blood insulin, glycosylated hemoglobin, fasting blood glucousewere measured in the four groups.

Results With the evolvement of diabetes nephropathy(DN), UAERs were gradually ascended and the values of GFR and ERPF was gradually descended, the former offered remarkable inverse correlation with the two latters(r₁=－0.497, P < 0.05;r₂=－0.215, P < 0.05).The values ofGFR and ERPF in four groups patientswith hypertension was lower than with out hypertension(t₁= 1.8, t₂=2.1, t₃=1.9, P < 0.05;t₄=3.2, P < 0.01).Multielement stepwise regression analyses assumed that age, systolic pressure, glycosylated hemoglobin and insulin resistance index offered inverse correlation with GFR and ERPF(coefficient of regression factor: －0.507、－0.874, －0.528、－0.587, －0.336、－0.697, －0.348、－0.371, P < 0.01).

Conclusion GFR and ERPFwere sensitive index reflecting the changes of DN.Hypertension and insulin resistance were independence risk factors to make the value of GFR and ERPF decreased in patients with DN.