核素肾动态显像对非胰岛素依赖型糖尿病患者肾功能的研究

Radionuclide dynamic renal imaging for renal function study in patients with NIDDM

为了解非腆岛素依赖型糖尿病(NIDDM)患者的肾功能,为临床治疗和预后判断提供依据,对137例 NIDDM 患者和44例正常对照者(NC)进行^(99m)Tc-DTPA 肾动态显像,同时获肾小球滤过率(GFR)和肾功能曲线;其中126例 NIDDM患者和另17例 NC 行^(99m)Tc-双半胱氨酸(EC)肾小管分泌功能测定。结果:不同病期各组 NIDDM 患者的 GFR 均显著低于NC(t=7.17～13.73,P<0.01)。2种显像剂用于测定肾小管分泌功能,不同病期组 NIDDM 心者的峰时均较 NC 明显后延(t=3.15～8.25,P<0.01);不同病期10和20分钟残存率均升高,与 NC 比较,以^(99m)Tc-EC 测定结果更为明显(t=2.11～2.18,P<0.05和 t=2.76～7.21,P<0.01)。因此,NIDDM 患者的肾脏滤过和分泌功能均受损,其程度随病期的延长而加重。

PURPOSE Radionuclide dynamic renal imaging was performed to gain evidence for further treatment and evalua- tion of prognosis in patients with non-insulin-dependent diabetes mellitus (NIDDM).METHODS ^(99m)Tc-DTPA dynamic renal imaging was performed in 137 NIDDM patients and 44 normal controls (NC).Glomerular filtration rate (GFR) and renogram were acquired simultaneously.Renal tubular secretion function wins measured with ^(99m)Tc-EC in 126 of the 137 diabetics and 17 NC.RESULTS GFR decreased in all patients witb different duration of NIDDM and the difference was remarkahly significance in comparision with NC (t=7.17～13.73,P<0.01).The results of renogram performed with above two imaging agents demon- strated that,compared with NC,peaktime was more distinctly delayed in all diabetics(t=3.15～8.25,P<0.01);retention rate increased in 10 and 20 min.Its increasing level was especially higher in patients with NIDDM than that in NC (t=2.11～2.18, P<0.05,t=2.76～7.21,P<0.01) and more significant with ^(99m)Tc-EC.CONCLUSIONS This study showed that the function of glomerular filtration and tubular secretion were both damaged in all diabetics.Their magnitude was aggravated with the prolon- gation of the course of disease.