首页> 中文期刊> 《安徽医科大学学报》 >99mTc-DTPA肾动态显像联合尿β2-MG测定评估妇科肿瘤患者化疗肾功能损伤的应用价值

99mTc-DTPA肾动态显像联合尿β2-MG测定评估妇科肿瘤患者化疗肾功能损伤的应用价值

         

摘要

Objective To explore the significance of 99mTechnetium-diethyene triaminepentaacetic acid(99mTc-DT-PA) renal dynamic imaging of glomerular filtration rate ( GFR) , apex time( Tb) , half excretion time( C1/2 ) and u-rine β2-microglobulin(β2-MG) determination in the evaluation of early renal function damage of patients with gyne-cological tumor after cis-diaminodichloroplatinum( DDP) chemotherapy. Methods 98 cases of patients with gyne-cological tumor were enrolled in this study. Self-contrasted method was used. The data of GFR,Tb,C1/2 by 99mTc-DTPA renal dynamic imaging and blood urea nitrogen ( BUN) ,serum creatinine ( SCr) levels in blood,β2-MG level in blood&urine from pre-chemotherapy and post-two-period-chemotherapy were compared by paired t test. Results All cases showed a significant decrease in GFR(P<0. 05)and a significant increase of Tb and C1/2(P<0. 01) after two periods of chemotherapy and β2-MG in urine(P<0. 01),the changes of BUN,SCr and β2-MG levels in blood were not singnificant. Conclusion The changes of GFR,Tb, C1/2 by 99mTc-DTPA renal dynamic imaging andβ2-MG level in urine precede those of BUN,SCr and β2-MG levels in blood, which will be helpful to evaluate the early renal function damage caused by DDP chemotherapy in patients with gynecologic tumors, and rational admin-istration and the observation and protection of renal function.%目的:探讨应用99mTc-亚锡喷替酸(99mTc-DTPA)肾动态显像测定肾小球滤过率( GFR)、高峰时间( Tb )和半排时间( C1/2)联合尿β2-微球蛋白(β2-MG)含量测定,评估其在妇科肿瘤顺铂( DDP)化疗时肾功能早期损伤的诊断价值。方法用自身对照法对98例妇科肿瘤患者在首次化疗前与化疗2周期后行99m Tc-DTPA肾动态显像,测定GFR、Tb、C1/2,同期测定血尿素氮( BUN)、肌酐( SCr)以及血、尿β2-MG含量。应用配对t检验对比观察。结果98例患者化疗2周期后较化疗前GFR明显下降(P<0.05),而Tb、C1/2显著延长(P<0.01);尿β2-MG含量明显升高(P<0.01),而血中BUN、SCr、β2-MG 变化均不明显。结论与测定血 BUN、SCr、β2-MG含量比较,99m Tc-DTPA肾动态显像测定GFR、Tb、C1/2及尿β2-MG含量,能发现含DDP化疗患者肾功能早期的损伤,对于临床合理用药、观察和保护肾功能有一定的参考价值。

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