核医学肾动态显像与血清胱抑素C评价肾积水患者肾功能的应用价值

The application value of renal dynamic imaging and serum cystatin C for kidney GFR evaluation in patients with hydroperinephrosis

目的 :探讨肾动态显像和血清胱抑素C(cystatin C,Cys C)评价肾积水患者肾功能的应用价值。方法 :回顾性收集2011年5月—2015年5月72例影像学检查确诊肾积水患者和15例健康人。肾积水患者根据影像检查分为轻度肾积水组、中度肾积水组及重度肾积水组,以双血浆法测定的肾小球滤过率(r GFR)为标准,所有患者均行肾动态显像(获得I-GFR)测定Cys C(获得C-GFR),考察其对肾功能的评估和联合应用价值。结果 :肾动态显像诊断肾积水灵敏度和特异性高,健康人组、轻度肾积水组患者,I-GFR与r GFR差异无统计学意义,但均略低于C-GFR;中度肾积水患者I-GFR(95.7±36.3)m L/min明显高于r GFR(79.7±11.8)m L/min,重度肾积水患者I-GFR(42.4±23.9)m L/min明显低于r GFR(54.7±11.8)m L/min,且I-GFR离散度大;对中、重度肾积水患者,C-GFR与r GFR差异无统计学意义。肾动态显像可有效评估非积水肾脏GFR,联合C-GFR,可获得积水侧肾脏GFR。结论:核医学肾动态显像对肾积水患者GFR评价方面具有明显优势,对中、重度肾积水患者分肾功能,与Cys C具有较好的联合应用价值。

Objective：To i nvestigate the application value of renal dynamic imaging and serum cystatin C（Cys C） for kidney function evaluation in patients with hydronephrosis. Methods：A total of 72 patients with hydroperinephrosis and 15 healthy people was retrospectively studied in our hospital from May 2011 to July 2015. All patients accepted99Tcm-DTPA renal dynamic imaging（Renal imaging） and serum cystatin C examinatioin for GFR calculation with r GFR as gold standard. Results：The diagnostic sensitivity and specificity of99Tcm-DTPA renal dynamic imaging for hydroperinephrosis was 100%. There was no significant difference between I-GFR and r GFR in mild hydroperinephrosis goup while C-GFR was higher than r GFR. The I-GFR value was higer than r GFR in patients with moderate hydroperinephrosis while it was lower than r GFR in patients with severe hydroperinephrosis. There was no significant difference between C-GFR and r GFR in patients with moderate or severe hydroperinephrosis.99Tcm-DTPA renal dynamic imaging,quantifying GFR of the kidney without hydroperinephros is and it also can effectively evaluate GFR of the kidney with hydroperinephros is when combined with serum Cys C. Conclusion：Renal dynamic imaging has great advantage for early dectction and GFR evaluation of the healthy kidney in patients with hydroperinephros. And it has great potential for precise GFR evaluation of the separate kidney in patients with moderate to severe hydroperinephros when combined with serum Cys C.