摘要:
目的 探讨131I-邻碘马尿酸盐肾图与肾盂积水和肾功能的关系,为临床进一步明确肾盂积水的诊疗提供可靠依据。方法 回顾性分析120例泌尿外科住院患者的肾图结果。肾盂积水者按单侧、双侧积水和轻、中、重度分组。分析各组肾图图形特点及其肾图功能参数值15 min残留率、浓缩率和肾脏指数变化规律,并与临床肾功能评价结果和血尿素氮、肌酐水平进行比较。采用SPSS。16统计软件进行统计分析。结果 不同程度肾盂积水的肾图异常率显著高于无积水者(98.9%对39.3%,χ2=87.492,P<0.01);轻、中度积水主要表现为高水平延长线和持续上升型肾图,重度积水则主要表现为低水平延长线型肾图;不同程度的积水均使15 min残留率增高、浓缩率和肾脏指数降低(F=74.56,20.0,61.917,P<0.001);双肾积水的肾功能不全发生率明显高于单肾积水(55%/11%,χ2=13.848,P<0.001),且肾功能不全程度较重,其血尿素氮和肌酐水平明显高于单肾积水(F=13.671,24.302,P<0.001);单肾积水者双肾肾图功能参数平均值与血尿素氮和肌酐水平存在一定程度的相关性。结论 131I-邻碘马尿酸盐肾图评估肾盂积水程度和肾功能变化敏感性较高,但缺乏特异性,应结合临床进行分析。
Abstract:
Objective To investigate the 131I-orthoiodohippurate renography with hydronephrosis and renal function,in order to further clarify the clinical diagnosis and treatment of hydronephrosis and provide a reliable basis.Methods Retrospective analysis the results of 131I-ortboiodohippurate renography in 120patients whose urology inpatients.In accordance with the side of hydronephrosis,bilateral hydronephrosis and light,moderate and severe packet.The features of renography and the changes of functional parameter values in each group was analysised.And compared with the results of clinical evaluation about renal function and blood urea nitrogen(BUN),creatinine(Cr)levels.SPSS.16 statistical software was used for statistical analysis.Results The incidence of abnormal renal funetion in varying degrees of hydronephrosis were significantly higher than those without hydronephrosis(98.9% vs.39.3%,χ2=87.492,P<0.001).Presenting mainly high level and extension line and continued to inerease for the type of renography in mild to moderate degree hydronephrosis groups.Severe hydronephrosis is presenting mainly such as the low level and extension line for the type of renography.Varying degrees of hydronephrosis different have meant that the residual rate of increase of 15 minutes,both of the Enrichment rate and renal index(RI)is lower(F=74.56,20.0,61.917,P<0.001).The incidence of Renal insufficiency in the group of bilateral hydronephrosis was significantly higher than the unilateral hydronephrosis(55% vs 11%,χ2=13.848,P<0.001).And the extent of severe renal insuflciency,serum BUN and Cr levels were significantly higher than the group of unilateral hydronephrosis(F=13.671,24.302,P<0.001).The average of the functional parameters that both sides of renography there is a certain degree of correlation with BUN,Cr in the unilateral hydronephrosis group.Conclusion The 131I-orthoiodohippurate renography there is a higher sensitivity on the assessment of hydronephrosis and renal function,but lack of specificity.The analysis should be combination with clinical situation.
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