急性脑血管病患者肾血流灌注研究

The renal perfusion in patients with acute cerebrovascular diseases

目的探讨急性脑血管病患者伴肾功能异常的机制及早期监测指标。方法应用99mTc-DTPA肾动态显像观察148例急性脑血管病（脑梗死80例、脑出血68例）及64名健康人的肾小球滤过率（GFR）及综合清除曲线等指标。结果急性脑血管病患者存在不同程度的肾血流灌注障碍，43．7％（35／80）的脑梗死和38．2％（26／68）的脑出血患者GFR异常，脑梗死组病灶对侧GFR降低，急性脑血管病的肾综合清除曲线异常，以抛物线型和排泄延迟居多。结论肾功能显像有助于早期发现肾功能损害；治疗脑血管病的同时应注意保护肾功能。

Objective To explore the mechanism and the early indicator of the renal impairmentassociated with acute cerebrovascular disease (ACVD). Methods With 99m Tc-DTPA dynamic renal imaging,weevaluated the renal function of the ACVD (148 cases) and the control group (64 cases). Result The renalperfusions of ACVD showed some disturbances. The glomerular filtration rate (GFR) of cerebral infarction(43. 7%) and cerebrl hemorrhage (38. 2%) were abnormal. Particularly in the infarction group, the contralateralGFR of the brain lesion decreased. The abnormalities of the renal clearance curve were mainly in the shape of aparabola with the delay of elimination. Conclusion These suggested that radionuclide renal imaging wouldfacilitate the early diagnosis of the renal impairment, and in the therapy of the ACVD the renal function should beprotected.