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1、2003年第43卷第21期山东医药肾功能临床相关指标诊断小儿先天性肾积水的评价姜立新郭宗远吴荣德于启海(山东省立医院山东济南250021)【摘要】目的探讨肾功能临床相关指标对小儿先天性肾积水的诊断价值。方法用99mTc-DTPA核素动态显像测定68只患肾和14只正常肾的肾小球滤过率(GFR),并与年龄及临床常规血检的血清尿素氮(BUN)、血清肌酐(SCr)、血红蛋白(Hb)进行相关性分析。结果GFR与正常儿童年龄呈正相关(r=0.428,P<0.05);中、重度肾积水患儿GFR与Hb呈正相关(分别为r=0.341、P<0
2、.05,r=0.635、P<0.01);GFR与BUN只在重度肾积水呈负相关(r=-0.559,P<0.05);GFR与SCr呈显著负相关(r=-0.445,P<0.01);中、重度肾积水肾功能显著性下降(P<0.05,P<0.001),轻度积水肾与正常肾肾功能无显著性差异(P<0.05)。结论GFR与SCr是检测小儿先天性肾积水肾功能的理想指标;BUN不适于肾积水的早期诊断;临床诊断明确的小儿先天性肾积水应早期手术治疗,以防止肾功能下降至失代偿而造成局部和全身性损害。【关键词】先天性肾积水核素肾动态显像99mTc-二巯
3、基丁二酸肾功能试验【Abstract】ObjectiveToassessthevalueoftheclinicalfactorscorrelatetorenalfunctionindiagnosisofchildrenwithcongenitalhydronephrosis.Methods68unilateralkidneyswithhydronephrosisand14normalkidneyswerestudiedby99mTc-DTPArenaldynamicimagingandglomerularfiltrati
4、onrate(GFR)quantitativeanalysiswasperformed.Ageandbloodureanitrogen(BUN),serumcreatinine(SCr)andHemoglobin(Hb)weredeterminedsimultaneouslyandtheywereallperformedcorrelationanalysiswithGFR.ResultsPositivecorrelationwasdiscoveredbetweenGFRandAge(r=0.428,P<0.05),pos
5、itivecorrelationbetweenGFRandHbwasalsodiscoveredinchildrenwithmoderateandseverehydronephrosis(r=0.341、P<0.05,r=0.635P<0.01);GFRwasnegitivecorrelatedwithBUNonlyinseverehydronephrosis(r=-0.559,P<0.05);GFRwasnegitivecorrelatedsignificantlywithSCr(r=-0.445,P<0.01);th
6、erenalfunctionwasdecreasedsignifi-cantlyinmoderate(P<0.05)andseverehydronaphrosis(P<0.001),andnosignificantdifferencebetweenmildgroupandnormalone(P>0.05).ConclusionsGFRandSCrweretheidealmarkersforestimatingrenalfunc-tioninchildrenwithhydronephrosis;BUNcouldnotbea
7、idealmarkerforearlydiagnosisofhydronephrosis;Childrenwithhydronephrosisshouldbeadministratedsurgicalprocedureassoonaspossibleinearlytime.【Keywords】CongenitalhydronephrosisNucliderenaldynamicimaging99mTC-dimorcaptosuccinicacidRenalfunctiontests中图分类号:R726.9文献标识码:A先
8、天性肾积水是小儿泌尿系统常见病,其中关对比分析,以探讨诸多临床指标的价值。现报告如85%以上是因肾盂输尿管交界处梗阻所致。因此,治下。疗过程中对判断患肾功能非常重要。目前评价肾功1资料与方法能的临床指标较多,但并不都能反映肾脏的实际功1.1临床资料根据肾脏B超、CT及IVP分度确99m能。核素动态显像(Tc-DTPA
