用肾图定量分析法评价系统性红斑狼疮患者的肾脏损害

目的　探讨系统性红斑狼疮患者肾功能损害的敏感指标。方法　用 99m Tc-DTPA作示踪剂 ,对 5 8例患者进行常规肾显像 ,测定肾小球滤过率 ,并对肾图进行定量分析。结果　用 Gates法计算的肾小球滤过率与肌酐清除率有高度相关性。肾小球滤过率的改变与患病时间长短无关。本组中肾图异常者为5 0 % ,但肾图经定量分析后 ,半排时间、15分钟残余率的异常率分别为 93.1%和 85 .3% ,远较临床综合判断有 6 7.3%的患者肾功能受损为高。即使是肾小球滤过率在正常范围时 ,亦有 88.5 %的患者显示半排时间延长。此外 ,半排时间与 15分钟残余率对肾异常的检出率比尿素氮和 (或 )肌酐明显为高。结论　对肾图进行定量分析可提高其对肾脏功能损害判断的敏感性。

Clinical Significance of Renal Im aging in Pateints with SL E by Quantitative Renogram

Objective To investigate the sensitive indexes which can diagnose early renal damage in SL E.Methods We used radioisotope renogram with99m Tc-DTPA as a tracer,to exam ine the glom erular filtration rate(GFR) and assessed renogram quantitatively in 5 8patients.Results The results show ed that the GFR calculated by the Gates m ethod correlated well w ith creatinine clearance rate,but had no correlation with the duration of the disease.O nly5 0 % of the patients showed abnorm al renogram.There w ere abnorm al half clearance tim e and 15 -m inute residual ratio in 93.1% and 85 .3% of the patients re- spectively after quantitative renogram analysis.However,there were only 6 7.3% of patients had renal dam age clinically,the positive rates of half clearance tim e and 15 -m inute residual ratio were much higher than those found by clinical examination.Even w hen GF R was norm al,there were88.5 % of the patients show ed prolonged half clearance tim e.We also found that half clearance tim e and 15 -minute residual ratio w ere m uch m ore sensitive than blood urea nitrogen or/and creatinine clearance rate determination.Conclu- sion The results suggest that quantitative renogram analysis m ay increase the sensitivity in assessing the renal dam age.