肾动态显像联合尿微量蛋白诊断红斑狼疮早期肾损害的价值探讨

Diagnostic Value of Renal Dynamic Imaging and Urinary Trace Protein in Patients with Lupus Nephritis at Early Stage

目的探讨^(99)Tc^m-DTPA肾动态显像、尿微量蛋白联合检测对狼疮性肾炎(LN)患者的早期诊断价值。方法正常对照组20例,实验组为SL,E患者42例,其中有肾脏表现组30例,无肾脏表现组12例。以^(99)Tc^m-DTPA肾动态显像观察肾小球滤过率(GFR),放免法检测尿微量蛋白。结果 SLE患者有肾脏表现组的GFR值和尿微量蛋白与无肾脏表现组、对照组比较,差异均有显著性(P<0.001);无肾脏表现组GFR值与对照组相比差异无显著性(P>0.05),但尿微量蛋白与对照组相比差异有显著性(P<0.05)。有肾脏表现组GFR诊断阳性率为91.5%,无肾脏表现组GFR诊断阳性率为80.4%,而肾动态显像、尿微量蛋白联合检测的诊断阳性率为98.4%.结论肾动态显像、尿微量蛋白联合检测可作为SLE患者早期肾功能损伤的检测指标,诊断准确性优于单纯肾功能显像。

Objective The aim of this paper is to explore diagnostic value of renal dynamic imaging and uri- nary trace protein in patients with lupus nephritis at early stage. Methods Twenty normal persons and forty-two patients with LN were examined by ^99Tc^m-DTPA renal dynamic imaging and urinary trace protein. The patients were divided into two groups. The first group named silent lupus nephritis（ SLN ） including 30 patients. The other group named obvious lu- pus nephritis（OLN ） including 12 patients. In each case,all the items including glomerular filtration rate（GFR） ,urinary trace protein were observed. Results There was obvious difference between normal person and two groups of LN patients in GFR and urinary trace protein（ P 〈 0. 001 ） , there was no difference between normal persons and SLN patients in GFR （P 〉 0.05 ） obvious in urinary trace protein { P 〈 0.05 ）. The positive rate was 91.5 % in SLN patients, and 80.4% in OLN patients by GFR,but 98.4% by GFR and urinary trace protein on the same time. Conclusion ^99Tc^m-DTPA renal dynamic imaging and urinary trace protein are a very efficient way to evaluate renal function for LN patients at early stage, and better than simple renal dynamic imaging.