肾脏深度对SPECT测定肾小球滤过率的影响

目的 评估6种肾脏深度估算公式对^99mTc-DTPA肾动态显像测定肾小球滤过率(GFR)的影响。 方法 以232名北京地区健康居民为研究对象,分别采用双血浆法和^99mTc-DTPA肾动态显像法测定GFR(GFR_dt和GFR_Gates)。分析6种肾脏深度估算公式所得GFR_Gates与GFR_dt间的相关性及一致性。 结果 公式1和5所得肾脏深度显著低于其他公式,公式3和6所得GFR_Gates与GFR_dt的相关性最好(r=0.81)。公式1和5所得GFR_Gates与GFR_dt一致性最差,差值均值分别为(-23.62±18.60)ml/(min·1.73 m²)、(-20.66±18.00)ml/(min·1.73 m²);公式3和4所得GFR_Gates与GFR_dt一致性最好,差值均值分别为(-5.80±16.76)ml/(min·1.73 m²)和(-3.81±17.87)ml/(min·1.73 m²)。 结论 肾脏深度估算公式1、2、5准确性较差,其他公式结果差异较小;公式3、4和6均可用于临床,但公式3和4更优。

Impact of kidney depth on the measurement of glomerular filtration rate with SPECT

Objective To explore the impact of kidney depth obtained with 6 different estimation formulas on measurement of glomerular filtration rate (GFR) with ^99mTc-DTPA renal dynamic imaging. Methods Totally 232 Beijing community health residents were selected as the research subjects. Two-sample method and ^99mTc-DTPA dynamic renal imaging were used for determination of GFR (GFR_dt and GFR_Gates, respectively). Six estimation formulas were used to obtain kidney depth applying for calculating GFR_Gates and GFR_dt. Correlation and consistency of GFR_Gates and GFR_dt were analyzed. Results The kidney depths derived from formula 1 and 5 were significantly lower than that of other 4 formulas. GFR_dt and GFR_Gates derived from formula 3 and 6 had the best correlation (r=0.81). The consistency between GFR_Gates derived from formula 1 and 5 and GFR_dt was the worst, with the mean difference of (-23.62±18.60)ml/(min·1.73 m²) and (-20.66±18.00)ml/(min·1.73 m²), respectively. The consistency between formula 3 and 4 derived GFR_Gates was the best with the mean difference of (-5.80±16.76)ml/(min·1.73 m²) and (-3.81±17.87)ml/(min·1.73 m²), respectively. Conclusion The accuracy of kidney depth estimation formula 1, 2, 5 are poor, while there are smaller differences among other formulas. Formula 3, 4 and 6 can be used clinically, whereas formula 3 and 4 are better.