肾动态显像对肾病综合征的诊断价值分析

The Clinical Value of ^(99)Tc^m-DTPA Renal Dynamic Imaging in Nephrotic Syndrome

目的探讨99Tc-mDTPA(二乙三胺五醋酸)肾动态显像诊断肾病综合征(NS)的价值。方法对照组20例,NS组38例,以99Tcm-DTPA为显像剂,利用SPECT肾动态显像观察肾小球滤过率(GFR),高峰时间(Tp),半排时间(T1/2),20min排泄率(R20)等各项功能指标及肾皮质显影情况,并与尿蛋白和血浆白蛋白检查结果进行对比分析。结果99Tcm-DTPA肾动态显像对NS的诊断阳性率(82.25%)明显高于尿蛋白和血浆白蛋白检查(63.20%)。肾动态显像中各指标对NS的早期诊断价值各有侧重,单个指标的诊断效能较小或一般。结论全面分析99Tcm-DTPA肾动态显像,对早期NS的早期诊断具有重要价值。

Objective To analyse the clinical value of ^99Tc^m-DTPA renal dynamic imaging in nephrotic syndrome （NS）. Methods Twenty normal persons and thirty-eight patients with nephrotic syndrome were examined by ^99Tc^m-DTPA renal dynamic imaging. In each case, glomerular filtration rate （GFR）, the time reaching highest aggregation （Tp）, the time of half excretion （T1/2）, the excretion rate at 20min （R20） and the imaging character of the renal were all observed. For all the items, the diagnosis value index including Sensitivity, chief Accordance and Kappa was calculated. Simultaneously, the urine protein and plasma albumin result was noted for every cases. The diagnosis results of ^99Tc^m-DTPA renal dynamic imaging were made respectively by two doctors without knowning the urine protein and plasma albumin result of the case. Results The sensitivity of ^99Tc^m-DTPA renal dynamic imaging in diagnosing NS （82.25%） was higher than that of urine protein and plasma albumin （63.2%, P〈0.05）. All the items ^99Tc^m-DTPA renal dynamic imaging had respective value in diagnosis, but their single value was much lower than that of the diagnosis results made by doctors through general analysis. Conclusion ^99Tc^m-DTPA renal dynamic imaging is a very efficient way to evaluate renal function. It is very important to generally analyse all the items of ^99Tc^m-DTPA renal dynamic imaging in order to dignose NS at early stage.