摘要
目的分析肾动静态联合显像与 IgA 肾病(IgAN)病理学改变的关系。方法选取肾脏组织病理检查证实为 IgAN 的患者20例,对其肾小球、肾小管间质和血管损害程度进行 Katafuchi积分和 Lee 分级。患者均接受^(99)Tc^m-DTPA 肾动态显像,其中13例另行^(99)Tc^m-二巯基丁二酸(DMSA)肾静态显像。图像经处理后获得灌注指数(PI)、肾小球滤过率(GFR)和肾/本底摄取比值(K/B)等参数。分别选择10例和4例健康体格检查者作为肾动静态显像正常对照。分析显像指标与病理积分间的关系,并比较各 Lee 分级的 PI、GFR 及 K/B 比值。结果 PI 与血管损害积分呈正相关(左 r=0.640、右 r=0.725;P 均<0.01),GFR、K/B 比值与肾小球损害(GFR:总 r=-0.731、左 r=-0.729、右 r=-0.718,K/B 比值:左 r=-0.714、右 r=-0.686,P 均<0.01)及肾小管间质损害积分(GFR:总 r=-0.619、左 r=-0.628、右 r=-0.595,K/B:左 r=-0.712、右 r=-0.716;P 均<0.05)呈负相关。随病理分级增高,PI 均值无明显变化(左 F=0.40、右 F=0.44,P 均>0.05),而 GFR 和 K/B比值均值逐级降低(GFR:总 F=52.23、左 F=48.59、右 F=29.66,K/B 比值:左 F=34.54、右 F=23.06;P 均<0.01)。结论肾动静态联合显像结果与肾脏组织病理学改变明显相关,其对 IgAN 病情评价及预后判断具有实用价值。
Objective To analyze the relationship between combined dynamic with static renal imaging and pathological changes in IgA nephropathy （IgAN）. Methods Twenty renal biopsy-proved IgAN patients were divided into three grades （ namely grade Ⅱ , Ⅲ, Ⅳ ） according to the Lee＇s histopathological classification. The extents of their renal pathological changes, including glomerular, tubulointerstitial, and vessel lesions were scored semi-quantitatively by Katafuchi＇s score system. All patients underwent renal dynamic imaging with ^99Tc^m-diethylene triamine pentoacetic acid （DTPA） and among them 13 patients also underwent static imaging with ^99Tc^m-dimercaptosuccinic acid （DMSA） within 1 week before or after biopsy. Through the imaging processing, the perfusion index （PI） , glomerular filtration rate （ GFR ） and uptake ratios of kidney to background （K/B） were obtained. Ten and four healthy adults were chosen as the control of dynamic and static imaging, respectively. The PI, GFR and K/B were compared among them, and the correlations between pathological scores and imaging parameters were analyzed. Results PI correlated positively with the vessel lesion score （ left r = 0. 640, right r = 0. 725 ; P 〈 0.01 ） , GFR and K/B correlated negatively with the glomerular lesion score （ GFR： total r = -0. 731, left r = -0.729, right r = -0. 718 ; K/B ： left r = - 0. ？ 14, right r = - 0. 686 ; all P 〈 0.01 ） and tubulointerstitial lesion score （ GFR ： total r = -0.619, left r= -0.628, right r= -0.595; K/B： left r= -0.712, right r= -0.716; all P〈0.05）. As the grade become higher, the average PI hardly increased （ left F = 0.40, right F = 0.44 ; P 〉 0.05 ）, while the average GFR and K/B gradually decreased （ GFR： total F = 52.23, left F = 48.59, right F = 29. 66; K/B： left F=34.54, right F=23.06; all P〈0.01 ）. Conclusion Dynamic and static renal ima- ging correlate closely with the pathological changes of IgAN, and demonstrate that they have practical value for the evaluation and prognosis of IgAN.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2006年第5期287-289,共3页
Chinese Journal of Nuclear Medicine
基金
湖北省卫生厅基金资助项目（JX1B004）
