摘要
目的利用99mTc-DTPA肾动态显像研究肾癌患者单侧肾切除前后留存肾功能的变化情况,探讨其在留存肾功能判断的临床应用价值。方法选取85例手术前后肌酐(Cr)、尿素氮(BUN)均正常的肾癌患者,单侧肾切除术前及术后1年分别行99mTc-DTPA肾动态显像,比较留存肾手术前后肾血流灌注、肾功能动态变化及定量指标肾小球滤过率(GFR)、肾脏指数(RI)、峰时(tb)、峰值、肾脏半排时间(C1/2)、20min残留率(20min/peak ratio)及血清学指标Cr,BUN的变化,并进一步计算术后留存肾GFR,tb,C1/2、20min/peak ratio的95%置信区间,获得肾切除术后上述指标的正常参考值范围及肾功能异常判断标准。结果留存肾GFR,tb,20min/peak ratio术后均较术前增高,差异均有统计学意义(P<0.05)。C1/2、峰值、RI手术前后变化差异无统计学意义(P>0.05)。术后留存肾GFR 95%置信区间下限为43.35ml/min,tb,C1/2,20min/peak ratio95%置信区间上限分别6.00min,30.95min,0.81。结论留存肾GFR<43.35ml/min,tb,C1/2,20min/peak ratio95%置信区间上限分别6.00min,30.95min,0.81,任一指标超过上限,均表明留存肾排泌功能不良。
Objective To study the changes of solitary renal function in patients with renal carcinoma before and after unilateral nephrectomy by using the renal 99 mTc-DTPA dynamic imaging,and the clinical application value of which in the judgment of solitary renal function.Methods To select 85 patients with renal carcinoma,whose Cr,BUN kept normal before and after unilateral nephrectomy,during May 2014 to August 2017 in the Affiliated Hospital of Weifang Medical University.Use 99 mTc-DTPA dynamic imaging on them before and 1 year after the operation and discuss the change of blood perfusion,renal function and the quantitative index of GFR,RI,tb,C1/2,20 min/peak ratio and Cr,BUN.The 95% confidence interval of retained renal GFR,tb,C1/2 and 20 min/peak ratio was further calculated to obtain the normal reference value range of the above indicators after nephrectomy and the evaluation index of renal dysfunction.Results In this study,the GFR of the residual kidneys,tb,20 min/peak ratio after operation were statistically higher than those before operation(P<0.05).There were no significant difference in peak value,RI before and after the operation.The lower limit of the 95% confidence interval of the solitary renal GFR was 43.35 ml/min,The upper limits of the tb,C1/2,and 20 min/peak ratio 95% confidence intervals were 6.00 min,30.95 min,and 0.81,respectively.Conclusion If the retained renal GFR was lower than 43.35 ml/min,then the renal function was considered to be impaired.If any of the above indicators exceeded the upper limit,the residual renal excretion function was considered to be poor.
作者
李旭
刘志翔
王元清
刘元奎
王岩
LI Xu;LIU Zhixiang;WANG Yuanqing;LIU Yuankui;WANG Yan(Department of Nuclear Medicine,Weifang Medical University,Weifang 261053,China;Department of Nuclear Medicine,the Affiliated Hospital of Weifang Medical University)
出处
《潍坊医学院学报》
2019年第3期164-166,175,共4页
Acta Academiae Medicinae Weifang
基金
潍坊市科学技术发展计划项目立项课题(课题编号:2013YD147)
潍坊市卫生计生委科研项目计划立项课题(课题编号:2017wsjs087)
关键词
单侧肾切除术
肾癌
肾动态显像
留存肾GFR
Unilateral nephrectomy
Renal carcinoma
Renal dynamic imaging
Solitary kidney
Normal reference
