核素肾动态显像诊断糖尿病肾病的研究

Study of diabetes mellitus nephropathy diagnosed with radionuclide renal dynamic imaging

目的探讨核素肾动态显像诊断糖尿病肾病(DN)的价值,为临床治疗和预后判断提供依据。方法将25例糖尿病患者根据尿蛋白定性和定量结果分成无蛋白尿组10例和蛋白尿组15例,另选择健康者14例作为对照组。所有受试者均行核素肾动态显像,并同时测定血肌酐(Cr)、血尿素氮(BUN)、尿白蛋白(ALB)水平。结果无蛋白尿组肾小球滤过率(GFR)及滤过分数(FF)高于对照组(P<0.05和P<0.01);蛋白尿组GFR及肾有效血浆流量(ERPF)明显低于对照组(P<0.01),FF、血Cr、尿ALB高于对照组(P<0.01和P<0.05)。GFR、ERPF与病程、血Cr、BUN、尿ALB显著负相关(P<0.01和P<0.05)。结论核素肾动态显像可早期诊断DN,并可了解肾功能的受损程度,为治疗方案的选择提供依据。

Objective It is to discuss the vah,e of radionuclide renal dynamic imaging for diabetes mellitus nephropathy （DN） so as to provide reference for clinical treatment and prognosis predicting. Methods 25 patients with diabetes mellitus were divided into non-proteinuria group （10 cases） and proteinuria group （36 cases） according to the results of proteinuria qualitation and quantitation. 14 healthy people were chosen as control group. Radionuclide renal dynamic imaging was performed and the levels of blood creatinine （Cr）, blood urea nitrogen （BUN） and urine albumin （ALB） were measured in the three groups, Results In non-proteinuria group, the GFR and FF were higher than those in control group （P 〈 0.05 and P 〈 0.01 ）. In the proteinuria group, the GFR and ERPF were obviously lower （P 〈 0.01）, the FF and the levels of blood Cr, BUN and urine ALB were higher than those in control group （P 〈 0.01 and P 〈 0.05 ）. GFR and ERPF had negative correlation with disease course and the levels of blood Cr, BUN, urine ALB （P 〈 0.01 and P 〈 0.05）. Conclusion Radionuclide renal dynamic imaging is helpful for the diagnosis of early stage of DN and damage extent of renal function so it can provide evidences for the choices of therapeutic regimen.