肾动态显像计算DEI、GFR在慢性梗阻性肾积水患者诊断及预后预测中的应用价值分析

Analysis of the application value of DEI and GFR calculated by renal dynamic imaging in the diagnosis and prognosis prediction of patients with chronic obstructive hydronephrosis

目的探讨肾动态显像计算利尿排泄指数(diuretic excretion index,DEI)、肾小球滤过率(glomerular filtration rate,GFR)在慢性梗阻性肾积水患者诊断及预后预测中的应用价值。方法选取慢性梗阻性肾积水患者82例作为研究组,健康体检者45例作为对照组。比较2组DEI和GFR,分析慢性梗阻性肾积水的影响因素,评价DEI和GFR对慢性梗阻性肾积水的诊断价值,比较不同肾积水程度患者的肾动态显像参数,分析肾动态显像参数与肾积水程度的相关性,分析DEI、GFR在慢性梗阻性肾积水患者1个月预后预测中的应用价值。结果研究组肾动态显像参数DEI、GFR低于对照组(P<0.05);DEI、GFR均是慢性梗阻性肾积水的影响因素(P<0.05)。DEI、GFR诊断慢性梗阻性肾积水的曲线下面积(area under the curve,AUC)分别为0.784、0.827,联合预测的AUC最大,为0.910;重度组DEI、GFR低于中度组、轻度组,中度组DEI、GFR低于轻度组(P<0.05);慢性梗阻性肾积水患者DEI、GFR与肾积水程度呈负相关(r=-7.360、-8.015,P<0.05)。DEI、GFR高水平患者术后1个月无肾功能率低于低水平患者(P<0.05);慢性梗阻性肾积水患者DEI、GFR与无肾功能率呈负相关关系(r=-0.614,-0.653,P<0.05)。结论肾动态显像计算DEI、GFR在慢性梗阻性肾积水的诊断及预后预测中具有一定应用价值。

Objective To investigate the application value of diuretic excretion index(DEI)and glomerular filtration rate(GFR)calculated by renal dynamic imaging in the diagnosis and prognosis prediction of patients with chronic obstructive hydronephrosis.Methods Eighty-two patients with chronic obstructive hydronephrosis were selected as the research group,and 45 healthy people undergoing physical examination during the same period were selected as the control group.The DEI and GFR of the two groups were compared,the influencing factors of chronic obstructive hydronephrosis were analyzed,and the diagnostic value of DEI and GFR in chronic obstructive hydronephrosis was evaluated.The renal dynamic imaging parameters of patients with different degrees of hydronephrosis were compared,and the correlation between renal dynamic imaging parameters and the degree of hydronephrosis was analyzed.The application value of DEI and GFR in the 1-month prognosis prediction of patients with chronic obstructive hydronephrosis was analyzed.Results The renal dynamic imaging parameters DEI and GFR in the research group were lower than those in the control group(P<0.05).Both DEI and GFR were influencing factors of chronic obstructive hydronephrosis(P<0.05).The area under the ROC curve(AUC)of DEI and GFR for the diagnosis of chronic obstructive hydronephrosis was 0.784 and 0.827,respectively,and the AUC of combined detection was the largest(0.910).DEI and GFR were lower in patients with severe chronic obstructive hydronephrosis than in patients with moderate and mild disease,and lower in patients with moderate disease than in patients with mild disease(P<0.05).DEI and GFR were negatively correlated with the degree of hydronephrosis in patients with chronic obstructive hydronephrosis(r=-7.360,-8.015,P<0.05).Patients with high DEI and GFR had a lower rate of no renal function at 1 month after surgery,as compared with those with low DEI and GFR(P<0.05).There was a negative correlation between DEI,GFR and the rate of no renal function in patients with chronic obstructive hydronephrosis(r=-0.614,-0.653,P<0.05).Conclusion Calculation of DEI and GFR by renal dynamic imaging has certain application value in the diagnosis and prognosis prediction of chronic obstructive hydronephrosis.