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目的探讨99Tcm-DTPA肾动态显像对系统性红斑狼疮(SLE)(LN)患者早期肾功能损害的诊断价值。方法正常对照组22例,实验组为SLE患者45例,其中狼疮肾炎(LN)组33例,非LN组12例,LN组根据血清肌酐测定值分为肌酐正常组(肌酐<100μmol/L)15例、肌酐异常组(肌酐>100μmol/L)18例。以99Tcm-DTPA肾动态显像观察肾小球滤过率(GFR)、20分钟排泄率(R20)。结果LN患者肌酐正常组和异常组的GFR值及R20值与对照组比较均有显著性差异(P均<0.01),SLE患者非LN组GFR值与对照组相比无差异(P>0.05)但R20值与对照组比较有显著性差异(P<0.01)。SLE患者非LN组GFR和R20的诊断阳性率分别为29.2%和45.8%。LN患者肌酐正常组GFR和R20的诊断阳性率分别为86.7%和93.3%,LN患者肌酐异常组GFR和R20的诊断阳性率均为100%。结论全面分析99Tcm-DTPA肾动态显像,对LN患者肾功能损害的早期诊断具有重要价值。
Objective To investigate the value of 99Tcm-DTPA renal dynamic imaging in the diagnosis of early renal dysfunction in patients with systemic lupus erythematosus (SLE) (LN). Methods Twenty-two normal controls were enrolled in this study. The experimental group consisted of 45 SLE patients, including 33 with LN and 12 without LN. LN was divided into normal creatinine group (creatinine <100μmol / L) 15 cases, abnormal creatinine group (creatinine> 100μmol / L) in 18 cases. Glomerular filtration rate (GFR) and excretion rate (R20) at 20 minutes were measured by 99Tcm-DTPA renal dynamic imaging. Results GFR and R20 in normal and abnormal creatinine group were significantly different from those in control group (all P <0.01). There was no difference in GFR between non-LN group and control group (P> 0.05) However, the R20 value was significantly different from the control group (P <0.01). The positive rates of GFR and R20 in non-LN patients were 29.2% and 45.8% respectively in SLE patients. The positive rates of GFR and R20 in LN patients with normal creatinine were 86.7% and 93.3%, respectively. The positive rates of GFR and R20 in LN patients with abnormal creatinine were 100%. Conclusions A comprehensive analysis of 99Tcm-DTPA renal dynamic imaging is of great value in the early diagnosis of renal damage in patients with LN.