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目的探讨用99Tcm-DTPA肾动态显像联合β2-微球蛋白(β2-microglobulin,β2-MG)检测在糖尿病患者早期肾功能损害诊断中的价值。方法将71例2型糖尿病患者根据尿蛋白排泄率分成4组:对照组(15例)、DM1组(糖尿病正常白蛋白组,13例)、DM2组(糖尿病微量白蛋白尿组,29例)和DM3组(糖尿病临床蛋白尿组,29例)。比较肾小球滤过率、肾有效血浆流量、肾功能曲线峰时、半排时间(T1/2)及20 min残留率(C20)。采用放射免疫分析方法测定血、尿β2-MG的含量。结果 DM1组GFR和ERPF均明显高于对照组(P<0.05),DM3组GFR和ERPF明显低于对照组(P<0.05)且DM2组和DM3组左肾、右肾和总T1/2延长,TP后延,C20明显高于对照组,差异均有统计学意义(P<0.05)。与对照组比较,患者血、尿β2-MG含量显著增高(P<0.05)。结论99Tcm-DTPA肾动态显像联合β2-MG检测可早期了解糖尿病患者肾脏受损程度。
Objective To investigate the value of 99Tcm-DTPA renal dynamic imaging combined with β2-microglobulin (β2-MG) in the diagnosis of early renal damage in diabetic patients. Methods 71 patients with type 2 diabetes were divided into 4 groups according to urinary protein excretion rate: control group (15 cases), DM1 group (diabetic normal albumin group, 13 cases), DM2 group (diabetic microalbuminuria group, 29 cases) And DM3 group (diabetic clinical proteinuria group, 29 cases). Glomerular filtration rate, effective renal plasma flow, peak renal function curve, half-time (T1 / 2) and residual rate (C20) of 20 min were compared. Radioimmunoassay was used to determine the content of β2-MG in blood and urine. Results GFR and ERPF in DM1 group were significantly higher than those in control group (P <0.05). GFR and ERPF in DM3 group were significantly lower than those in control group (P <0.05), and left and right kidney and total T1 / 2 in DM2 group and DM3 group were prolonged , TP delayed, C20 was significantly higher than the control group, the differences were statistically significant (P <0.05). Compared with the control group, blood and urine β2-MG levels were significantly increased (P <0.05). Conclusion 99Tcm-DTPA renal dynamic imaging combined with β2-MG test can early understand the degree of renal damage in diabetic patients.