论文部分内容阅读
目的 :评估肾小球滤过率(glomerular filtration rate,GFR)联合血清肌酐、尿素氮和尿酸对单侧肾积水的临床意义。方法:,对176例单侧肾积水患者和22例肾移植供体行放射性核素99Tcm-DTPA肾动态显像检查进行GFR功能的测定,用Gate’s法测得分肾GFR值;采用分光光度法检测血清肌酐、尿素氮和尿酸。结果:在176例单侧肾积水患者中,经B超检查诊断轻度、中度和重度单侧肾积水患者分别为21、33和122例。与肾移植供体单侧肾GFR值为(50.69±4.54)m L/min相比:轻度积水患者单病肾GFR值(48.33±12.12)m L/min未见明显下降(P>0.05);中度肾积水单病肾GFR值(29.32±9.00)m L/min和重度肾积水单病肾GFR值(13.61±14.38 m L/min)均明显下降(P<0.01)。所有病肾对侧健康肾脏的分肾GFR值均高于肾移植供体的单侧肾GFR值,有显著性差异(P<0.01)。随单侧肾积水程度从轻度、中度加重到重度积水的过程中,病肾GFR值越来越低,血清尿酸水平逐渐增高;而血清的肌酐、尿素氮未见明显变化。结论:高尿酸血症可能是单侧肾积水的致病原因之一,Gate’s法测得的分肾GFR值可直观评估单侧肾积水分肾功能受损情况,为后继治疗方案的选择提供了直接的依据。而肌酐、尿素氮因对侧健肾强大的代偿功能,故对评估单侧肾积水肾功能的价值有限。
Objective: To evaluate the clinical significance of glomerular filtration rate (GFR) combined with serum creatinine, urea nitrogen and uric acid in the treatment of unilateral hydronephrosis. Methods: The GFR function of 99Tcm-DTPA radionuclide in 176 patients with unilateral hydronephrosis and 22 renal transplant recipients was determined. The GFR of kidney was measured by Gate’s method. Serum creatinine, urea nitrogen and uric acid were measured. RESULTS: Among 176 patients with unilateral hydronephrosis, 21, 33 and 122 patients with mild, moderate, and severe unilateral hydronephrosis were diagnosed by B-mode ultrasound. Compared with the GFR of unilateral kidney in renal transplant recipients (50.69 ± 4.54) m L / min, there was no significant difference in GFR (48.33 ± 12.12) m L / min in mild hydronephrosis (P> 0.05 ). GFR (29.32 ± 9.00) m L / min and GFR (13.61 ± 14.38 m L / min) in severe hydronephrosis were significantly decreased in moderate hydronephrosis (P <0.01). GFR values of renal allografts in all contralateral kidney were higher than GFR in unilateral kidney in kidney transplant recipients, with significant difference (P <0.01). With the degree of unilateral hydronephrosis mild to moderate severe hydrocephalus, kidney disease GFR value is getting lower and lower, serum uric acid levels gradually increased; serum creatinine, urea nitrogen no significant change. Conclusions: Hyperuricemia may be one of the causes of unilateral hydronephrosis. The GFR value measured by Gate’s method can directly evaluate the renal function impairment of unilateral hydronephrosis, which is the choice of follow-up treatment Provide a direct basis. The creatinine, urea nitrogen due to contralateral kidney strong compensatory function, so the assessment of unilateral hydronephrosis renal function is of limited value.