核素血浆标本法肾小管功能测定的临床应用

Clinical application of renal tubular function determination from radionuclide sample plasma

目的 评价放射性核素血浆标本法肾小管摄取率 (TER)的临床价值。方法 正常对照组 5 0例 ,可引起肾功能损害的各种疾病 5 3例。用核素血浆标本法测定TER及有效肾血浆流量 (ERPF) ,用放射免疫法测定尿 - β2 微球蛋白 (U - β2 MG) ,按U - β2 MG水平将患者分成 3组。结果 正常组TER(ml·min-1·1 73m-2 )为 2 5 4,疾病 1～ 3组TER(ml·min-1·1 73m-2 )分别为 2 2 7、186及 75 (P <0 .0 5 ) ,U - β2 MG(mg/L)分别为 0 .0 83、0 .45 5及 14.2 9。TER与U - β2 MG的相关系数r为 -0 4 814(P <0 .0 0 1) ,与ERPF的r为 0 .980 7(P <0 .0 0 1)。正常组TER的变异系数 (CV)为 11.4%。轻、中度肾小管功能受损时 ,TER与U - β2 MG有部分不一致 ,重度肾小管功能受损时两者均异常 ,一致性很好。结论 TER可反映肾小管功能受损程度 ,与ERPF的相关性很好 ,正常组的CV小 ,方法简单、安全 ,只需 40min ,是一较好的肾小管功能指标。

Objective To assess the clinical value of tubular extraction rate(TER)from radionuclide sample plasma.Methods Fifty normal controls and 53 patients were studied using 148 MBq 99 m Tc-MAG 3.TER and effective renal plasma flow(ERPF)were determined from radionuclide plasma sample and urine β 2-microglobulin(U-β 2MG)was determined by radioimmunoassay.Patients were classified into 3 groups according to U-β 2MG.Results TER (ml·min -1 ·1.73 m -2 ) was 254 in normal group and 227,186 and 75 (P<0.05) in patients' groups 1～3,respectively.U-β 2MG(mg/L) was 0.083,0.455 and 14.29 in groups 1～3,respectively.The correlation coefficient r was -0.481 4(P<0.001) between TER and U-β 2MG and was 0.980 7(P<0.001) between TER and ERPF.The coefficient of variation(CV) of TER was 11.4% in normal group.Conclusion TER can reflect the damage degree of renal tubular function,has good correlation with ERPF and has less CV in the control.This method is advanced,simple,safe and needs just 40 min so it is a good parameter of renal tubular function.