不同病理类型IgA肾病肾动态显像分析

Analysis of renal dynamic imaging with radionuclide in patients with different IgA nephropathies

目的 探讨肾动态显像在判断各类IgA肾病的组织病变程度及预后中的价值。方法70例经肾活组织检查证实的IgA肾病患者根据病理分级进行分组 ,比较各组肾功能变化。结果 肾动态显像测得的肾小球滤过率 (GFR)与实验室检查测得的血肌酐 (SCr)和尿素氮 (BUN)水平基本一致 ;肾功能受损患者的GFR下降早于SCr的升高 ,GFR是反映肾功能变化敏感而可靠的指标 ;早期出现核素 2 0min清除率 (C2 0 )的下降则提示较重的病理改变。

Objective To explore the value of renal dynamic imaging with radionuclide in patients with different IgA nephropathies (IgAN). Methods Seventy cases of IgAN determined by nephrocentesis were divided into 4 groups according to their pathologic classification. The glomerular filtration rate (GFR) and radionuclide clearance at 20 min (C 20 ) were measured and the differences of functional parameters among the groups were compared. Results The GFR was concordant with the serum creatinine (SCr) and blood urea nitrogen (BUN), and changed earlier than the increase of BUN and SCr in renal failure. GFR is a reliable index of renal filtration function. Moreover, the reduced C 20 association with severe pathologic changes was observed, especially in patients with interstitial lesions. Conclusion The renal dynamic imaging with 99 Tc m DTPA is of important value in assessing the renal function and the prognosis in patients with IgAN.