CAJ | 학술논문

目的探讨Gates法测定GFR的精确性,及其与肾病理改变之间的相互关系,获得Gates法测定GFR的适用范围.方法选取99Tcm-DTPA肾功能曲线中双肾均无明显b段(即无超滤液形成段,A组)及双肾均有明显b段(B组)肾病患者各27例,比较Gates法测定GFR与CockcroftGault(C-G)公式、肾病膳食改良试验(MDRD)方程评估GFR及SCr之间的相关性,2组间病理结果(肾小球硬化分数和肾小管间质病变分数)差异行t检验比较.结果线性相关分析证实:A组中,Gates法测定的GFR与C-G公式、1/SCr之间无明显相关性(r=0.357,0.376,P均＞0.05)与MDRD方程估算的GFR有明显相关性(r=0.440,P＜0.05);B组中,Gates法测定的GFR与C-G公式、MDRD方程估算的GFR及1/SCr之间有正相关性(r=0.471,0.527,0.452,P均＜0.05).A组肾小球硬化分数与B组差异无统计学意义,分别为0.26±0.24,0.27±0.21(t=-0.146,P＞0.05),A组肾小管间质病变分数与B组差异有统计学意义,且较B组严重,分别为7.15±2.32,3.70±3.06(t=4.663,P＜0.001).结论 99Tcm-DTPA肾功能曲线中双肾均无明显b段时,Gates法测定GFR的精确度明显低于双肾有明显b段者;99Tcm-DTPA肾功能曲线中双肾无明显b段与肾小管间质严重病变相关.
목적 탐토Gates법측정GFR적정학성,급기여신병리개변지간적상호관계,획득Gates법측정GFR적괄용범위.방법 선취99Tcm-DTPA신공능곡선중쌍신균무명현b단(즉무초려액형성단,A조)급쌍신균유명현b단(B조)신병환자각27례,비교Gates법측정GFR여CockcroftGault(C-G)공식、신병선식개량시험(MDRD)방정평고GFR급SCr지간적상관성,2조간병리결과(신소구경화분수화신소관간질병변분수)차이행t검험비교.결과 선성상관분석증실:A조중,Gates법측정적GFR여C-G공식、1/SCr지간무명현상관성(r=0.357,0.376,P균＞0.05)여MDRD방정고산적GFR유명현상관성(r=0.440,P＜0.05);B조중,Gates법측정적GFR여C-G공식、MDRD방정고산적GFR급1/SCr지간유정상관성(r=0.471,0.527,0.452,P균＜0.05).A조신소구경화분수여B조차이무통계학의의,분별위0.26±0.24,0.27±0.21(t=-0.146,P＞0.05),A조신소관간질병변분수여B조차이유통계학의의,차교B조엄중,분별위7.15±2.32,3.70±3.06(t=4.663,P＜0.001).결론 99Tcm-DTPA신공능곡선중쌍신균무명현b단시,Gates법측정GFR적정학도명현저우쌍신유명현b단자;99Tcm-DTPA신공능곡선중쌍신무명현b단여신소관간질엄중병변상관.
Objective To evaluate the precision of GFR using Gates method and compared with the results from renal pathological changes. Methods Twenty-seven patients whose 99Tcm-DTPA renograms had no obvious uptake phase were enrolled in Group A, and 27 patients whose 99Tcm-DTPA renograms had obvious uptake phase were enrolled in Group B. The measurement of GFR by Gates method was compared to the creatinine clearance measured and predicted by Cockroft-Gault (C-G), modification of diet in renal disease (MDRD) and SCr level. Renal pathological changes in two groups were compared using Pearson correlation and t test analysis. Results In Group A, GFR determined by Gates method did not show correlation with that estimated by C-G or 1/SCr (r = 0. 357,0. 376, both P ＞0.05), but was significantly correlated with GFR estimated by MDRD(r = 0. 440, P ＜ 0.05). In Group B, GFR determined by Gates method showed significantly correlation among GFR estimated by MDRD, C-G, and 1/SCr (r =0. 471, 0. 527,0. 452, all P ＜ 0.05). Renal tubulointerstitial damage score in Group A was higher than that in Group B (7.15±2.32, 3.70±3.06, t=4.66, P ＜0.001). Conclusions GFR determined by Gates method is less precise when 99Tcm-DTPA renogram has no obvious uptake phase than that when 99Tcm-DTPA renogram has obvious uptake phase. Renal tubulointerstitial damage is a strong indicator of no obvious uptake phase in 99Tcm-DTPA renogram.