CT尿路造影对肾脏病变患者肾小球滤过率的评估效果

Evaluation Effect of CT Urography on Glomerular Filtration Rate in Patients with Renal Lesions

目的探讨CT尿路造影对肾脏病变患者肾小球滤过率的评估效果。方法将2018年3月至2019年3月本院的肾脏病变患者126例按年龄大小不同分为低龄组(20~35岁)、中龄组(36~50岁)、高龄组(51~65岁),各42例,对所有患者均行CT尿路造影、99mTc-喷替酸盐(99mTc-DTPA)检查,测得其肾小球滤过率(GFR),分析比较两种检查方法测得的GFR在低龄组、中龄组、高龄组的相关性,分别比较两种检查方法测得的GFR在低龄组、中龄组、高龄组中与肾实质体积(RPV)的相关性。结果在低龄组、中龄组、高龄组中,CT尿路造影与99mTc-DTPA测得的GFR均成明显的正相关关系(r=0.628、0.821、0.810,P﹤0.05);在低龄组,CT尿路造影与99mTc-DTPA测得的GFR与RPV无明显相关关系(P﹥0.05),在中龄组、高龄组,两者均与RPV成明显正相关性关系(r=0.623/0.513,0.835/0.642,P﹤0.05),且CT尿路造影检查测得的GFR与RPV的相关系数大于99mTcDTPA检查测得的GFR与RPV的相关系数。结论CT尿路造影检查与99mTc-DTPA检查一样,可较准确地评估各个年龄段的肾脏病变患者GFR水平,且在中高龄患者中,与RPV的相关性较99mTc-DTPA检查与RPV的相关性高,更能反映RPV的变化,有望成为临床评价肾功能的一种新方法。

Objective To explore the evaluation effect of CT urography on glomerular filtration rate(GFR)in patients with renal lesions.Methods According to different age,126 patients with renal lesions in the hospital during the period from March 2018 to March 2019 were divided into low-age group(20~35years),middle-age group(36~50 years)and advanced-age group(51~65 years),42 cases in each group.All underwent CT urography and 99mTc-acid salt spray(99mTc-DTPA)examination to detect their GFR.The correlation of GFR measured by the two examination methods in the three groups were analyzed and compared.The correlation of GFR measured by the two examination methods with renal parenchymal volume(RPV)was compared among the three groups.Results In low-age,middle-age and advanced-age groups,GFR measured by CT urography was significantly positively correlated with GFR measured by 99mTc-DTPA(r=0.628,0.821,0.810,P﹤0.05).In low-age group,GFR measured by CT urography and 99mTc-DTPA was not significantly correlated with RPV(P﹥0.05),while which was significantly positively correlated with RPV in middle-age and advanced-age groups(r=0.623/0.513,0.835/0.642,P﹤0.05).The correlation coefficient between GFR measured by CT urography and RPV was greater than that between GFR measured by 99mTc-DTPA and RPV.Conclusion Both CT urography and 99mTc-DTPA can accurately assess GFR level in renal lesions patients of different age groups.In middle-age and advanced-age patients,the correlation between GFR measured by CT urography and RPV is higher than that between GFR measured by 99mTc-DTPA and RPV,which can more reflect RPV changes,and is expected to be a new method for clinical evaluation of renal function.