同位素肾图对诊断糖尿病肾病的临床价值探讨

Clinical value of isotope renogram in diagnosis of diabetic nephropathy

目的探讨同位素肾图诊断糖尿病肾病的临床价值。方法 2008年至2011年34例2型糖尿病患者根据尿蛋白排泄率分为无蛋白尿、微量蛋白尿、临床蛋白尿三组进行了同位素肾图检查,与15例查体人员(正常对照组)同位素肾图比较,比较有效肾血浆流量,肾功能曲线峰时15 min残留率。结果 2型糖尿病无蛋白尿组、微量蛋白尿组、临床蛋白尿组分别与正常对照组比较,15 min残留率均升高;2型糖尿病并临床蛋白尿时,肾脏指数明显降低,有效肾血浆流量明显下降。结论同位素肾图能反映2型糖尿病早期肾病的肾脏血流动力学改变,可早期了解糖尿病患者肾脏受损程度,为临床治疗和随访提供依据。

Objective To study the clinical value of isotope renogram in diagnosis of diabetic nephropathy.Methods Totally 34 cases of type 2 diabetic patients from 2008 to 2011 were divided into no proteinuria group,microalbuminuria group and clinical proteinuria group according to urinary protein excretion rate.The effective renal plasma flows as well as residual rates of renal function curve peaked at 15 minutes of the three groups were compared with 15 healthy controls.Results The residual rates of renal function curve peaked at 15 minutes were gradually increased in all three groups compared with those of healthy controls.The kidney indexes and effective renal plasma flows were significantly lowered in patients of type 2 diabetes complicated with clinical proteinuria.Conclusion Isotope renogram can reflect the renal hemodynamic changes for diabetic nephropathy at early stage.The extent of kidney injury can be understood and references can be provided for clinical treatment and follow-up.