常用肾功能测定方法与^(99m)Tc-DTPA清除率的关系探讨

Relationship between renal function test and ^(99m)Tc-DTPA clearance rate

目的 为临床评估慢性肾功能衰竭患者的肾小球滤过率 (GFR)提供依据。方法 应用99mTc DTPA清除率测定68例慢性肾功能衰竭患者的GFR(Tc GFR) ,同时检测 2 4小时内生肌酐清除率 ( 2 4hCcr)和使用Ccockcroft Gault公式计算肌酐清除率 (Ccockcroft) ,然后进行分组比较和分析。结果 ① 2 4hCcr、Ccockcroft与Tc GFR的相关系数分别为 0 91和 0 83。②代偿期组的肌酐分泌率 (TScr/Tc GFR)高于对照组 ,失代偿期组、尿毒症前期组、尿毒症期组均低于对照组 ,并呈现出按代偿期组、失代偿期组、尿毒症前期组、尿毒症期组的顺序依次下降的趋势。结论 ① 2 4hCcr、Ccockcroft能在一定程度上较为准确地反映GFR ;但在代偿期、失代偿期和尿毒症前期都高于GFR ,尤以失代偿期显著。②动态观察和比较TScr/Tc

Objective To determine clinically adequate measurement of glomerular filtration rate(GFR) in patients with chronic renal failure.Methods 99m Tc DTPA clearance rate was used to determine the glomerular filtration rate(GFR) or glomerular filtration rate(Tc GFR) in 68 patients with chronic renal failure.At the same time,24 hour clearance rate of creatinine (24hCcr) was tested and Cockcroft was calculated with Gualt formula.Then comparison was made between the parameters in different groups.Results The correlation coefficients of 24hCcr and Ccockcroft with TcGFR were 0.91 and 0.83 respectively.In the group of compensatory phase, TScr/Tc and GFR were higher than those in the control group,wheras they were lower in the decompensatory preuraemic ,and uraemic groups than in the normal controls.A trend was shown that these two parameters were becoming increasingly lower in order of compensatory,decompensatory,preuraemic and uraemic groups.Conclusions The parameters 24hCcr and Ccockcroft could precisely reflect to some extent the change in GFR;in the compensatory,decompensatory and preuraemic phases,24hCcr and Ccoxkcroft were both higher than GFR,especially more remarkable in decompensatory phase.It might be of significance to observe dynamically the changes in Tscr/Tc and GFR for the judgement of severity of renal failure and its prognosis.