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目的:评价n 99Tcn m-二乙撑三胺五乙酸(DTPA)核素肾动态显像(Gates法)检测心脏移植患者肾小球滤过功能的准确性。n 方法:回顾性纳入2017年9月至2018年6月阜外医院拟行心脏移植手术的终末期心力衰竭的34例患者[男30例、女4例，年龄(45±14)岁)]为心脏移植组，另选择41例心功能正常患者作为对照组[男19例、女22例，年龄(50±17)岁]，均行Gates法和双血浆法(DPSM)测定肾小球滤过率(GFR)，分别为gGFR和dGFR。以DPSM为标准，验证Gates法的准确性。17例心脏移植组患者术后重复行Gates法及DPSM，依据Gates法测得的分肾比值估算DPSM测定的左右分肾GFR(dGFRL与dGFRR)。采用Pearson相关和配对n t检验分析数据。n 结果:心脏移植组的gGFR高于dGFR[(66.49±15.66)与(49.16±13.24) ml·minn －1·1.73 mn －2；n t＝6.728，n P<0.01]，两者呈中等相关(n r＝0.467，n P<0.01)；对照组gGFR与dGFR无明显差异 [(65.35±26.28)与(62.22±21.37) ml·minn －1·1.73 mn －2；n t＝1.268，n P＝0.212]，两者呈强相关(n r＝0.799，n P<0.01)；2组相关性的差异有统计学意义(n z＝－2.44，n P<0.05)。患者心脏移植术后肌酐水平呈下降趋势，而DPSM对应的dGFR、dGFRL、dGFRR均呈上升趋势，提示术后较术前肾功能改善。n 结论:99Tcn m-DTPA核素肾动态显像(Gates法)测定心脏移植患者GFR的准确性欠佳；DPSM结合Gates法的GFR联合测定方案可提供总体GFR并准确估算分肾GFR，或可作为可靠的心脏移植手术肾功能动态监测手段。n “,”Objective:To evaluate the accuracy of glomerular filtration rate (GFR) assessed from the renal dynamic imaging method (Gates method) with n 99Tcn m-diethylene triamine pentoacetic acid (DTPA) in the heart transplant population.n Methods:From September 2017 to June 2018, 34 patients with advanced heart failure who were prepared for surgery (30 males, 4 females; age: (45±14) years; heart transplant group) and 41 patients with normal heart function (19 males, 22 females; age: (50±17) years; control group) in Fuwai Hospital were respectively enrolled. GFRs of all patients were measured using Gates method (gGFR) and dual plasma sample method (DPSM; dGFR) with n 99Tcn m-DTPA. The accuracy of Gates method for detecting GRF was verified by using DPSM as the reference. Seventeen patients in heart transplant group underwent n 99Tcn m-DTPA renal dynamic imaging for Gates and DPSM results repeatedly after the surgery. The single kidney (left and right) functions (dGFRL and dGFRR) of DPSM were obtained according to the results of Gates method. Pearson correlation analysis and paired n t test were used to analyze the data.n Results:The gGFR in heart transplant group was higher than dGFR ((66.49±15.66) n vs (49.16±13.24) ml·minn -1·1.73 mn -2; n t=6.728, n P<0.01), and there was a moderate correlation between them (n r=0.467, n P<0.01). No difference between gGFR and dGFR in control group was observed ((65.35±26.28)n vs (62.22±21.37) ml·minn -1·1.73 mn -2; n t=1.268, n P=0.212), and there was a good correlation between them (n r=0.799, n P<0.01). The difference between 2 correlation coefficients was statistically significant (n z=-2.44, n P<0.05). Serum creatinine decreased, while dGFR, dGFRL and dGFRR increased after the surgery, suggesting the improved renal function.n Conclusions:The renal dynamic imaging method (Gates method) with n 99Tcn m-DTPA has less accuracy in the heart transplant patients. Combination of DPSM and Gates method can provide the precise total GFR and assess single kidney GFR, and may serve as a tool to monitor the renal function for the heart transplant patients in clinic.n