肾动态显像法与双血浆法测定糖尿病肾病患者GFR的比较

Comparison of glomerular filtration rates by dynamic renal scintigraphy and dual - plasma sample clearance method in diabetic nephropathy

目的 以双血浆法测得的肾小球滤过率（GFR）为参考标准，评价99Tcm-DTPA肾动态显像法测得的糖尿病肾病患者GFR的可靠性及准确性。方法选择46例确诊为糖尿病肾病的患者，分别采用肾动态显像法和双血浆法测定其GFR（GFR肾动态法和GFR双血浆法）。用配对t检验分析经体表面积标准化（1．73m^-2）的GFR肾动肾动态与GFR双血浆法间的差异有无统计学意义，并行相关性分析。结果46例糖尿病肾病患者的GfR肾动态法范围为1t．87～107．00ml·min^-1，均值为（51．08±26．78）ml·min^-1；GFR双血浆法范围为4．17-118．56ml·min^-1，均值为（44．06±29．43）ml·min^-1；两者间差异有统计学意义（t=4．209，P=0．000），前者略高于后者，且两者呈显著正相关（r=0．923，P=0．000），直线回归方程为GFR双血浆法=1．015×GFR肾动态法-7．773（F=254．656，P=0．000）。结论GFR肾动态法与GFR双血浆法的差异有统计学意义，对于糖尿病肾病患者尚不能用GFR肾自态法代替GFR双血浆法；但肾动态显像法能够较准确评价糖尿病肾病患者的肾滤过功能。

Objective To evaluate the accuracy of renal scintigraphy for the estimation of glomerular filtration rates （dGFR） in patients with diabetic nephropathy as compared to the conventional dual-plasma sample clearance method （pscGFR）. Methods Forty-six patients with diabetic nephropathy underwent both dynamic renal scintigraphy and dual-plasma sample measurement after 99Tcm-DTPA injection. Paired student t-test and correlation analysis were performed to compare dGFR and pscGFR （normalized to body surface area, 1.73 m^-2）. Results The mean dGFR was higher than mean pscGFR （（51.08 ±26.78） ml· min^-1 vs （44.06 ± 29.43 ） ml · min^-1 , t = 4. 209, P = 0. 000）. The dGFR correlated with pscGFR （ r = 0. 923, P = 0. 000） linearly （ regression equation ： pscGFR = 1. 015× dGFR - 7. 773, F = 254. 656, P = 0. 000）. Conclusions dGFR correlated well with pscGFR. Although it could not absolutely replace the latter in patients with diabetic nephropathy, dGFR could reasonably evaluate the filtration function for these patients.