核素肾动态显像诊断亚临床肝肾综合征

Radionuclide renal dynamic imaging in the diagnosis of subclinical hepatorenal syndrome

目的评价核素肾动态显像诊断亚临床肝肾综合征的价值。方法以９９ｍＴｃ＿ＤＴＰＡ为示踪剂，用肾动态显像对２７例正常人及２２例肝硬变患者进行观察。按ＳＣｒ浓度将２２例肝硬变患者分成两组，ＳＣｒ＜１３３μｍｏｌ／Ｌ者为肝硬变１组，＞１３３μｍｏｌ／Ｌ者为肝硬变２组．结果腹部Ｂ超检查２２例肝硬变患者为肝硬变，门脉高压，脾大，双肾正常．肝硬变１，２组的ＢＵＮ分别为５．３ｍｍｏｌ／Ｌ±１．８ｍｍｏｌ／Ｌ和７．１ｍｍｏｌ／Ｌ±３．８ｍｍｏｌ／Ｌ，ＳＣｒ分别为９１．５μｍｏｌ／Ｌ±１９．１μｍｏｌ／Ｌ和１４３．０μｍｏｌ／Ｌ±１３．８μｍｏｌ／Ｌ．肾动态显像显示２７例正常人均无肾盂滞留．肝硬变患者的双肾功能影像呈一致性改变，肝硬变１，２组分别有２５％和８３％存在轻度肾盂滞留．正常组，肝硬变１和２组的高峰时间（ＴＰ，ｓ）分别为１７６±３６，２２８±８６和４２６±１８７；全肾平均通过时间（ＫＭＴＴ，ｓ）分别为１０８±２５，１４０±４９和２５５±８３；２０ｍｉｎ／高峰（２０ｍｉｎ／ｐ）分别为３４±６，４２±１３和６４±１８；本底计数／高峰肾脏计数（ＢＧ／Ｋ）分别为２３±５，３４±９和３２±９；肾脏指数（ＲＩ）分别为５０±９，４０±?

AIM To diagnose subclinical hepatorenal syndrome by using radionuclide renal dynamic imaging. METHODS Normal volunteers ( n =27) and patients with cirrhosis ( n =22) were evaluated by using radionuclide renal dynamic imaging with Tc99m-DTPA. Patients with cirrhosis were classified into 2 groups according to serum creatinine(SCr). The concentration of SCr <133μmol/L was in group Ⅰ and >133μmol/L in group Ⅱ.