用^(99)Tc^m-DTPA肾动态显像判断2型糖尿病肾小球功能

Clinical study of GFR and split renal GFR in evaluating the glomerular function in patients with type 2 diabetes

目的 探讨用99Tcm DTPA肾动态显像判断 2型糖尿病患者肾小球功能的临床价值。方法正常对照者 12例 ,2型糖尿病患者 5 1例 ,根据尿微量白蛋白测定结果分组 ,分别行99Tcm DTPA肾动态显像测定总肾与分肾肾小球滤过率 (GFR)。结果 ① 2型糖尿病各组总肾及分肾GFR均低于对照组。②总肾及分肾GFR与尿微量白蛋白呈显著负相关 ,r分别为 - 0 4 5 7,- 0 4 12和 - 0 4 2 4 (P均 <0 0 1)。③ 5 1例 2型糖尿病患者中有 5例总肾GFR正常 ,而分肾GFR异常。结论 用99Tcm DTPA肾动态显像判断 2型糖尿病患者早期肾小球功能损害有一定价值。

Objective To assess glomerular filtration function in patients with type 2 diabetes by glomerular filtration rate (GFR) and split GFR, namely left GFR (LGFR) and right GFR (RGFR). Methods Fifty-one patients with type 2 diabetes were classified by urine albumin analysis into three groups, normalalbuminuria group(NA), microalbuminuria group(MA) and macroalbuminuria group(MAA). Twelve patients without diabetes were included into control group. 99Tcm-DTPA renography was performed on all these cases. GFR and split GFR were calculated by Gates fomula. Results ①GFR, LGFR and RGFR of NA group were lower than that of the control group. ②GFR, LGFR and RGFR were significantly correlated with the urine albumin level (r=-0.457, -0.412, -0.424, respectively, P all<0.01). ③In all 51 cases, there were 5 cases whose GFR were normal while split GFR were abnormal. Conclusions ①GFR and split GFR measurement can detect the incipient damage of glomerular function more sensitively than urine albumin analysis and show the degree of the damage correctly. ②Split GFR measurement can improve the evaluation of the glomerular function in type 2 diabetes patients.