9mTc-DTPA肾动态显像评价水化治疗预防对比剂致肾功能损伤的效果

摘要

目的 探讨99mTc-DTPA肾动态显像评价水化治疗预防对比剂致肾功能损伤的价值.方法 选择17例接受冠状动脉造影(CAG)检查的肾功能不全代偿期患者,入选患者术前12 h开始水化治疗,按照1～1.5 ml/(kg·h)输入生理盐水和5%NaHCO3注射液(125 ml),术后继续维持生理盐水输入12 h.CAG前24 h、后72 h分别行99mTc-DTPA肾动态显像,测定肾小球滤过率(GFR),同时测定血清尿素氮(BUN)、血清肌酐(Scr)进行对比分析.结果 17例患者术后双肾GFR、血BUN、Scr水平,与造影前比较,差异均无统计学意义(P均＞0.05).结论 99mTc-DTPA肾动态显像进一步证实了水化治疗预防对比剂导致肾功能损伤的有效性.%Objective To investigate the value of hydration therapy reviewed by m Tc-DTPA renal dynamic imaging in preventing contrast induced nephropathy. Methods The patients of compensatory stage of renal insufficiency ( n = 17 ) accepted coronary angiography ( CAG ) were selected and given hydration therapy 12 hours before CAG. They were infused normal saline solution[ 1 ~ 1. 5 ml/( kg ? H ) ]and 5% sodium bicarbonate injection ( 125 mL ) before CAG,and the infusion of normal saline solution was maintained for 12 hours after CAG. All patients were given "m Tc-DTPA renal dynamic imaging 24 hours before CAG and 72 hours after CAG. The glomerular filtration rate ( GFR ),blood urea nitrogen ( BUN ) and serum creatinine ( Scr ) were detected,compared and analyzed. Results The changes of GFR,BUN and Scr were not statistically different in 17 patients before and after CAG ( all P >0.05 ). Conclusion m Tc-DTPA renal dynamic imaging can confirm further the effect of hydration therapy in prevention and treatment of impaired renal function induced by contrast agent.