Wickham Fred, Burniston Maria T, Xirouchakis Elias, Theocharidou Eleni, Wesolowski Carl A, Hilson Andrew J W, Burroughs Andrew K
aNuclear Medicine Department bThe Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust cUCL Institute of Liver and Digestive Health, University College London, London, UK dMedical Imaging Department, University of Saskatchewan, Saskatoon, Saskatchewan eFaculty of Medicine, Memorial University of Newfoundland, St Johns, Newfoundland, Canada.
Nucl Med Commun. 2013 Nov;34(11):1124-32. doi: 10.1097/MNM.0b013e32836529ab.
The aim of this study was to identify a practical sampling regimen and calculation method that could be used to measure the glomerular filtration rate in patients with ascites using plasma sampling.
Thirteen potential liver transplant patients with cirrhosis and ascites were injected with Cr-51 ethylenediaminetetraacetic acid, and plasma samples were obtained at up to 16 time points for each patient. Reference clearance values were calculated using the area under the plasma clearance curve, which was calculated using all the available data points. Clearance calculations were then performed using three and four data points from each patient and three different calculation methods to identify a sampling regimen and calculation method that yielded good agreement with the reference values.
The reference clearances ranged from 6 to 80 ml/min. Sampling at 2, 4, 8 and 24 h and calculation of the area under the plasma clearance curve using a log-linear trapezoidal rule with extrapolation to zero and infinity yielded a relative root mean square difference from the reference of less than 7%.
This method for measuring glomerular filtration rate in patients with cirrhosis and ascites was found to be more accurate than the slope-intercept technique and is a practical alternative to urine collection.
本研究旨在确定一种实用的采样方案和计算方法，可用于通过血浆采样来测量腹水患者的肾小球滤过率。
对13例潜在的肝硬化和腹水肝移植患者注射铬-51乙二胺四乙酸，并为每位患者在多达16个时间点采集血浆样本。使用血浆清除曲线下面积计算参考清除率值，该曲线使用所有可用数据点计算得出。然后使用每位患者的三个和四个数据点以及三种不同的计算方法进行清除率计算，以确定与参考值具有良好一致性的采样方案和计算方法。
参考清除率范围为6至80毫升/分钟。在2、4、8和24小时进行采样，并使用对数线性梯形法则外推至零和无穷大来计算血浆清除曲线下面积，与参考值的相对均方根差小于7%。
发现这种用于测量肝硬化和腹水患者肾小球滤过率的方法比斜率截距技术更准确，并且是尿液收集的一种实用替代方法。
