99Tcm-DTPA肾动态显像与胱抑素C对肝病肾损害的诊断价值

目的探讨血清胱抑素C(Cys C)检测与99 Tcm-二乙三胺五醋酸肾动态显像(99 Tcm-DTPA RDI)在早期肝病肾损害中的价值。方法将65例肝病患者按照其内生肌酐清除率(CCr)值分为3组,并采用99 Tcm-DTPA RDI检测肾小球滤过率(GFR),同时测Cys C和血清肌酐(SCr)水平,采用统计学方法分析结果。结果在肝病患者中,99 Tcm-DTPA RDI测得的GFR与Cys C随SCr的下降呈明显改变,对早期肾脏的损害明显优于SCr(P<0.05)。相关性分析提示在肝病肾损害的患者中,Cys C、GFR与CCr有明显的负相关关系(P<0.001),而GFR相关性更高。结论 Cys C检测与99 Tcm-DTPA RDI在肝病患者中能更为早期准确地发现肾功能损害,对临床有效防止肝肾综合征的发生有着积极意义。

Value of 99Tcm-DTPA renal dynamic imaging and cystatin C for diagnosising renal injury in liver disease

Objective To probe into the clinical value of isotope 99Tcm-DTPA renal dynamic imaging(RDI) and serum cystatin C(CysC) for diagnosing early renal damage in liver disease.Methods 65 patients with liver disease were divided into three groups according to endogenous creatinine clearance(CCr) value.The glomerular filtration rate(GFR) was detected by the 99Tcm-DTPA RDI,and at the same time,Cys C and serum SCr were detected.The results were statistically analyzed.Results In the patietens with liver diseases,GFR detected by 99Tcm-DTPA RDI and Cys C showed significant change with declining of SCr,which were obviously superior to SCr in early renal damage(P<0.05).The correlation analysis revealed that in the patients with liver diseases complicating renal impairment,serum Scys C and GFR had obvious negative correlation with CCr(P<0.001) and GFR had the higher correlation.Conclusion Serum Cys C and 99Tcm-DTPA RDI can earlier found renal impairment in the patients with liver diseases,which plays the active significance to prevent the occurrence of hepatorenal syndrome.