~(99m)Tc-DTPA肾动态显像对2型糖尿病患者肾功能的评价

目的　探讨99mTc -二乙三胺五乙酸 (99mTc -DTPA)肾动态显像对 2型糖尿病患者肾功能的评价 ,为临床治疗和预后判断提供依据。方法　将 68例 2型糖尿病患者根据尿蛋白定性和定量结果分成无蛋白尿组 3 2例 (尿蛋白阴性 ,2 4h尿蛋白 <0 .5 g) ;蛋白尿组 3 6例 (尿蛋白阳性 ,2 4h尿蛋白≥ 0 .5 g)。并与正常对照组 2 3例进行99mTc -DTPA肾动态显像评价 ,比较获得肾小球滤过率 (GFR)、肾功能曲线峰时 (min)、2 0min残留率 (% )等参数。结果　无蛋白尿组GFR明显高于正常对照组 (P <0 .0 1) ;蛋白尿组GFR明显低于正常对照组 (P <0 .0 1)。两组 2型糖尿病患者肾功能曲线峰时、2 0min残留率均较正常对照组延长 (P <0 .0 1或 0 .0 5 )。结论　99mTc -DTPA肾动态显像可诊断 2型糖尿病肾病早期的GFR高滤过状态 ,并了解肾功能的受损程度 ,为临床治疗和随访提供依据。

99m Tc-DTPA renal dynamic imaging in judgment of the renal function in patients with type 2 diabetes mellitus

Objective To evaluate 99m Tc-DTPA renal dynamic imaging in judgment of the renal function in patients with type 2 diabetes mellitus so as to provide reference for clinical treatment and prognosis predicting. Methods 68 patients with type 2 diabetes mellitus were allocated to a nonproteinuria group (n=32, negative urinary protein, 24-hour urinary protein<0.5g) and a proteinuria group (n=36, positive urinary protein, 24-hour urinary protein≥0.5g). The comparison of the glomerular filtration rate (GFR), the renal function curve peak time and the 20-min residual rate parameters to the control group (n=23) had also been done. Results In the nonproteinuria group, the GFR was statistically higher than that in the control group (P<0.01); and the GFR in the proteinuria group was statistically lower than that in the control group (P<0.01). The renal function curve peak time and the 20-min residual rate in the two DM groups prolonged than that in the control group (P<0.01 or 0.05). Conclusion 99m?Tc-DTPA renal dynamic imaging can diagnose the GFR hyperfiltration state in type 2 diabetes mellitus, judge the injury of the renal function and provide reference for clinical treatment and follow-up.