^(99m)Tc-DTPA肾动态显像评价早期成人PNS患者AKI的临床价值

The clinical value of^(99m)Tc-DTPA renal dynamic imaging in evaluating AKI in early adult PNS patients

目的探讨^(99m)Tc-二乙烯三胺五乙酸(diethylenetriaminepentaacetic acid,DTPA)肾动态显像评价早期成人原发性肾病综合征(primary nephrotic syndrome,PNS)患者肾小管间质损伤的临床价值。方法选取早期成人PNS患者42例作为病例组,以病理结果有无肾间质损伤为标准,分析^(99m)Tc-DTPA肾动态显像定量指标和生化指标血肌酐(serum creatinine,SCr)、血尿素氮(blood urea nitrogen,BUN)、血尿酸(uric acid,UA)、血视黄醇结合蛋白(retinol-binding protein,RBP)、血β2-微球蛋白(β2-microglobulin,β2-MG)水平对肾小管间质损伤的诊断效能。结果①病例组患者的总肾小球滤过率(glomerular filtration rate,GFR)、左肾GFR、右肾GFR分别与血SCr、BUN、β2-MG水平呈负相关。②总GFR诊断早期成人PNS患者肾小管间质损伤的诊断效能优于血SCr、BUN、β2-MG,总GFR结合达峰时间(T_(p))、半排时间(T_(1/2))、20min残留率(R_(20/p))可进一步提高诊断效能。结论^(99m)Tc-DTPA肾动态显像对早期成人PNS患者肾小管间质损伤的早期诊断具有指导性意义。

Objective To explore the clinical value of ^(99m)Tc-diethylenetriaminepentaacetic acid(DTPA)renal dynamic imaging in evaluating renal tubulointerstitial injury in early adult primary nephrotic syndrome(PNS)patients.Methods A total of 42 early adult PNS patients were selected as case group,and the diagnostic efficacy of ^(99m)Tc-DTPA renal dynamic imaging quantitative indicators and biochemical indicators of serum creatinine(SCr),blood urea nitrogen(BUN),blood uric acid(UA),blood retinol-binding protein(RBP),and blood β2-microglobulin(β2-MG)levels in renal tubulointerstitial injury was analyzed based on pathological results with or without renal interstitial injury as the standard.Results①The total glomerular filtration rate(GFR),left kidney GFR and right kidney GFR were negatively correlated with blood SCr,BUN and β2-MG levels of patients in case group.②The diagnostic efficiency of total GFR in diagnosis of tubulointerstitial injury in early adult PNS patients is better than that of blood SCr,BUN andβ2-MG,total GFR combined with time to peak(T_(p)),half discharge time(T_(1/2))and 20 minute residual rate(R_(20/p))can improve the diagnostic efficiency.Conclusion ^(99m)Tc-DTPA renal dynamic imaging is helpful in early diagnosis of tubulointerstitial injury in early adult PNS patients.