目的分析肾动态显像在评价活体供肾者肾功能状况以及预测术后保留肾功能中的价值。方法36例供肾者术前均接受^99Tc—DTPA肾动态显像,计算出总肾和分肾GFR值(d—GFR)。供者于术前、术后3d、10d测定血清肌酐水平,利用简化MDRD方程计算GFR值(e-GFR);利用肾动态显像测得的分肾摄取率计算保留肾的术前e-GFR。将供者按不同指标分组,分别对各组间保留肾的术前、术后3d、10d的e-GFR值进行统计学分析。结果术前保留肾d-GFR值为(49.4±11.7)ml/min,e-GFR值为(54.7±8.7)ml/min。老年组术前保留肾、术后3d的e-GFR值显著低于中青年组;男性组术后e-GFR值和术后10d的e-GFR变化率均明显低于女性组;低d-GFR组术后3d、10d的e-GFR值显著低于高d-GFR组,差异有统计学意义;低e-GFR组和高e-GFR组两组间术后e-GFR的数值和变化率差异均无统计学意义。结论肾动态显像能够很好地评价活体供肾者的总肾和分肾功能,有助于预测供者术后肾功能的恢复情况。
Objective To explore the value of renal dynamic imaging in evaluating and predicting renal function of living donors before and after the renal ectomy. Methods A total of 36 living donors underwent ^99mTc-DTPA renal dynamic imaging before operation, and the total and split GFR value (d-GFR) were obtained. Blood creatinine was measured before oper ation, 3 and 10 d after operation, then the GFR value (e-GFR) was calculated with simplified MDRD equation. The donors were divided into different groups according to different indexes, and the e-GFR values before operation, 3 and 10 d after operation were analyzed using independent sample t test. Results Before the operation, d-GFR of the remaining renal was (49.4±11.7)ml/min and e-GFR was (54.7±8.7)ml/min. The e-GFR of the remaining renal before operation and 10 d after operation in the elder group was lower than that in the young group. The e-GFR after operation and change rate of e-GFR 10 d after operation in male group were lower than those in female group. The e-GFR 3 and 10 d after operation in low d- GFR group were lower than those in high d GFR group, and change rate of e-GFR 3 and 10 d after operation were also lower in low d GFR group, but there was no difference of the value and change rate of e-GFR after operation between high e-GFR group and low e-GFR group. Conclusion Renal dynamic imaging is valuable to assess the total and split renal function of living donors, and contributes to predict renal function of the donors after operation.