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目的探讨99mTc-DTPA肾动态显像评价婴幼儿肾积水肾功能的临床价值。方法用99mTc-DTPA肾动态显像,应用Gates法计算52例肾积水患儿76只患肾和28只正常肾在设定全肾ROI及肾皮质ROI时各自的肾小球滤过率(GFR),与同期血尿素氮(BUN)和血清肌酐(SCr)进行相关分析。结果①所有患儿的GFR与BUN无相关性;中、重度肾积水患儿GFR与SCr呈负相关(r=-0.518、-0.771,P<0.05、P<0.01)。②轻度肾积水患儿相对肾功能与正常肾差异无统计学意义(P>0.05);中、重度肾积水相对肾功能与正常肾比较则明显下降(P<0.05、P<0.01)。③轻度肾积水全肾ROI与肾皮质ROI计算的GFR无统计学意义差异(P>0.05);中、重度肾积水两种不同ROI计算的GFR差异有统计学意义(P<0.01)。结论99mTc-DTPA肾动态显像测定GFR是检测婴幼儿肾积水肾功能的理想指标。应用肾皮质ROI计算GFR对中、重度婴幼儿肾积水肾功能的判断及临床治疗的指导更灵敏、更准确。
Objective To investigate the clinical value of 99mTc-DTPA renal dynamic imaging in evaluating renal function of infants with hydronephrosis. Methods 99mTc-DTPA renal dynamic imaging was used to calculate the glomerular filtration rate (GFR) of 76 patients with renal hydronephrosis and 28 normal kidneys in 52 cases of hydronephrosis with Gates method GFR) and correlated with blood urea nitrogen (BUN) and serum creatinine (SCr) in the same period. Results ① There was no correlation between GFR and BUN in all children. GFR was negatively correlated with SCr in children with moderate and severe hydronephrosis (r = -0.518, -0.771, P <0.05, P <0.01). ② There was no significant difference in relative renal function and normal kidney between children with mild hydronephrosis (P> 0.05), moderate and severe hydronephrosis relative to normal kidney (P <0.05, P <0.01) . (3) There was no significant difference in GFR between mild hydronephrosis and renal cortex ROI (P> 0.05). There was a significant difference in GFR between moderate and severe hydronephrosis (P <0.01) . Conclusion 99mTc-DTPA renal dynamic imaging to determine GFR is an ideal indicator for detection of renal function in infants with hydronephrosis. Application of renal cortex ROI calculated GFR, hydronephrosis in infants and young children with renal function judgments and clinical guidance is more sensitive and more accurate.