GFR联合血清肌酐、尿素氮和尿酸评估单侧肾积水的临床意义

发布时间：2018-07-25 13:24

【摘要】：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(P0.05);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(P0.01)。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(P0.01)。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。
[Abstract]:Objective: to evaluate the clinical significance of glomerular filtration rate (glomerular filtration) combined with serum creatinine, urea nitrogen and uric acid in patients with unilateral hydronephrosis. Methods radioisotope 99Tcm-DTPA renal dynamic imaging was performed in 176 patients with unilateral hydronephrosis and 22 renal allograft donors. The GFR function was measured by Gate's, and the serum creatinine, urea nitrogen and uric acid were measured by spectrophotometry. Results: among 176 patients with unilateral hydronephrosis, the number of mild, moderate and severe unilateral hydronephrosis was 21 33 and 122, respectively. Compared with the donor kidney, the GFR value of unilateral kidney was (50.69 卤4.54) m L/min: the GFR value of mild hydronephrosis was (48.33 卤12.12) m L/min, the GFR value of moderate hydronephrosis was (29.32 卤9.00) m L/min and the GFR value of severe hydronephrosis was (13.61 卤14.38 m L/min) (P0.01). The GFR values of all the diseased contralateral healthy kidneys were significantly higher than that of the unilateral renal GFR (P0.01). With the degree of unilateral hydronephrosis from mild, moderate to severe hydronephrosis, the GFR value of the diseased kidney became lower and lower, the serum uric acid level gradually increased, but the serum creatinine and urea nitrogen did not change obviously. Conclusion: hyperuricemia may be one of the pathogenetic factors of unilateral hydronephrosis. The GFR values measured by the method of GatePins can directly evaluate the impairment of renal function in unilateral hydronephrosis, and provide a direct basis for the selection of subsequent treatment schemes. However, the value of creatinine and urea nitrogen in evaluating unilateral hydronephrosis is limited because of the strong compensatory function of contralateral healthy kidney.
【作者单位】：三峡大学第一临床医学院湖北省宜昌市中心人民医院泌尿外科;南京大学医学院附属鼓楼医院核医学科;
【基金】：南京市医学科技发展项目(YKK13063)
【分类号】：R692.2

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