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目的探讨99m锝-亚锡喷替酸(99mTc-DTPA)肾小球滤过率(GFR)测定评估肿瘤患者化疗后肾功能损伤的价值。方法肿瘤患者化疗后行单光子发射型计算机断层仪(SPECT)全身骨显像肾脏过度显影的63例,行GFR及血清尿素氮(BUN)、肌酐(SCr)和B2-微球蛋白(B2-MG)测定。按GFR水平分轻度降低组(15例,GFR 80-50ml/min)、中度降低组(31例,GFR 50-30ml/min)和重度降低组(17例,GFR<30ml/min)。对照组20例为未化疗的全身骨显像肾脏显影正常的肿瘤患者。比较四组血清BUN、SCr及B2-MG差异。结果 63例患者GFR均低于对照组。GFR中度降低时,血清B2-MG高于对照组(P<0.01)。GFR重度降低时,血清BUN及B2-MG均高于其他三组(P<0.01)。结论 99mTc-DTPA GFR测定对诊断肿瘤化疗后的早期肾损伤较血清BUN、SCr及B2-MG灵敏。
Objective To investigate the value of 99mTc-Tin (99mTc-DTPA) glomerular filtration rate (GFR) in assessing renal function after chemotherapy in patients with cancer. Methods Thirty-three patients with tumor over-developed by single-photon emission computed tomography (SPECT) bone scintigraphy after chemotherapy were treated with GFR and serum urea nitrogen (BUN), creatinine (SCr) and B2-microglobulin MG). The patients in the moderate reduction group (31 cases, GFR 50-30ml / min) and the severe reduction group (17 cases, GFR <30ml / min) were divided into mild reduction group (15 cases, GFR 80-50ml / min) The control group of 20 patients with non-chemotherapy of the whole body bone imaging normal renal tumor patients. Four groups of serum BUN, SCr and B2-MG differences. Results 63 cases of GFR were lower than the control group. When GFR was moderately decreased, serum B2-MG was higher than that of the control group (P <0.01). Serum BUN and B2-MG levels were significantly higher in GFR than in other three groups (P <0.01). Conclusion The 99mTc-DTPA GFR assay is sensitive to early kidney injury after chemotherapy for the diagnosis of cancer than BUN, SCr and B2-MG.