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目的 :探讨肾动态显像和血清胱抑素C(cystatin C,Cys C)评价肾积水患者肾功能的应用价值。方法 :回顾性收集2011年5月—2015年5月72例影像学检查确诊肾积水患者和15例健康人。肾积水患者根据影像检查分为轻度肾积水组、中度肾积水组及重度肾积水组,以双血浆法测定的肾小球滤过率(r GFR)为标准,所有患者均行肾动态显像(获得I-GFR)测定Cys C(获得C-GFR),考察其对肾功能的评估和联合应用价值。结果 :肾动态显像诊断肾积水灵敏度和特异性高,健康人组、轻度肾积水组患者,I-GFR与r GFR差异无统计学意义,但均略低于C-GFR;中度肾积水患者I-GFR(95.7±36.3)m L/min明显高于r GFR(79.7±11.8)m L/min,重度肾积水患者I-GFR(42.4±23.9)m L/min明显低于r GFR(54.7±11.8)m L/min,且I-GFR离散度大;对中、重度肾积水患者,C-GFR与r GFR差异无统计学意义。肾动态显像可有效评估非积水肾脏GFR,联合C-GFR,可获得积水侧肾脏GFR。结论:核医学肾动态显像对肾积水患者GFR评价方面具有明显优势,对中、重度肾积水患者分肾功能,与Cys C具有较好的联合应用价值。
Objective: To investigate the clinical value of renal dynamic imaging and serum cystatin C (Cys C) in evaluating renal function in patients with hydronephrosis. Methods: From May 2011 to May 2015, 72 patients with hydronephrosis diagnosed by imaging examination and 15 healthy people were retrospectively collected. Patients with hydronephrosis according to the imaging examination were divided into mild hydronephrosis group, moderate hydronephrosis group and severe hydronephrosis group, double plasma method to determine the glomerular filtration rate (r GFR) as a standard, all patients Cys C (C-GFR) was measured by renal dynamic imaging (obtained I-GFR), and its evaluation of renal function and its combined value were investigated. Results: The sensitivity and specificity of renal dynamic imaging in the diagnosis of hydronephrosis were high. There was no significant difference in I-GFR and r GFR between healthy people and mild hydronephrosis patients, but both were lower than those of C-GFR (95.7 ± 36.3) m L / min was significantly higher than that of r GFR (79.7 ± 11.8) m L / min in patients with degree of hydronephrosis, and I-GFR (42.4 ± 23.9) m L / min in patients with severe hydronephrosis was significantly Less than r GFR (54.7 ± 11.8) m L / min, and the I-GFR dispersion was large. There was no significant difference between C-GFR and r GFR in patients with moderate and severe hydronephrosis. Renal dynamic imaging can effectively assess the non-hydronephrotic kidney GFR, combined with C-GFR, hydronephrosis can be obtained kidney GFR. CONCLUSION: Nuclear medicine renal dynamic imaging has obvious advantages in evaluating GFR in patients with hydronephrosis and renal function in patients with moderate and severe hydronephrosis, and has good combined value with Cys C.