肾动态显像法与双血浆法在糖尿病肾病患者肾小球滤过率测定中的价值比较

摘要

Objective To compare the value of dynamic renal scintigraphy and dual-plasma sample clearance method in measuring glomerular filtration rate ( GFR) of patients with diabetic nephropathy.Methods 68 patients were divided into early nephropathy ( DN1 ) , clinical nephropathy (DN2) and uremia groups (DN3),the number of cases in each group was 23,23 and 22 respectively;22 cases of healthy controls ( DN0) were selected from the people of physical examination.The GFR of all the groups were measured both with dynamic renal scintigraphy and dual-plasma sample clearance method and analyzed.Results The gGFR and tGFR of DN0, DN1 and DN2 measured by dynamic renal scintigraphy and dual-plasma sample clearance method respectively had no significant differences (P>0.05),the differ-ences of gGFR and tGFR were significant in DN3 group( P<0.05);the correlation coefficient of gGFR and tGFR of four groups were 0.999, 0.947,0.925 and 0.999,respectively,which had significant differences (P<0.05).Conclusions Both dynamic renal scintigraphy and du-al-plasma sample clearance method could find the GFR change of early kidney disease and clinical kidney disease sensitively, but the accura-cy and sensitivity of dynamic renal scintigraphy in diagnosing patients with uremia period is poor, the diagnosis of uremia should combine the medical history with other examination methods.%目的：比较肾动态显像法与双血浆法在糖尿病肾病（DN）患者肾小球滤过率（GFR）测定中的价值。方法将该院内分泌科患者68例DN患者分为早期肾病组（DN1）23例、临床肾病组（DN2）23例、尿毒症组（DN3）22例，另选取该院22例健康体检者作为健康对照组（DN0），均用肾动态显像法和双血浆法测定其GFR，分析各组两种方法所测 GFR 的关系。结果 DN0、DN1及 DN2组组内用肾动态显像法和双血浆法测定的GFR（即gGFR与tGFR）相比均无明显差异（P＞0．05），DN3组gGFR与tGFR的差异具有统计学意义（P＜0．05）；DN0、DN1、DN2及DN3组肾动态显像法所测的GFR与双血浆法测定的GFR均呈正相关（P＜0．05）。结论肾动态显像法与双血浆法均可以灵敏地发现早期DN及临床 DN时 GFR的变化，但肾动态显像法对于尿毒症期的患者诊断准确性差、灵敏度低，应联合病史及其他检查方法进行诊断。