O'Reilly P H, Brooman P J, Martin P J, Pollard A J, Farah N B, Mason G C
Br Med J (Clin Res Ed). 1986 Jul 26;293(6541):234-6. doi: 10.1136/bmj.293.6541.234.
A new method for determining the glomerular filtration rate was analysed prospectively. The method uses an x ray fluorescence technique to measure disappearance from the plasma of injected non-ionic iodinated contrast media. Eighty seven patients were studied. Fifty four had an intravenous dose of 100 ml iohexol (Omnipaque) and 33 had 50 ml iohexol. Clearances of chromium-51 labelled edetic acid (51Cr-EDTA) were measured simultaneously. In the patients given 100 ml iohexol there was excellent correlation with 51Cr-EDTA clearance (r = 0.90). The correlation using 50 ml iohexol was also good (r = 0.85). Correlation between creatinine clearance and clearance of 51Cr-EDTA in 33 patients was less satisfactory (r = 0.69). There were no adverse reactions to the contrast media. The equipment used for measuring contrast clearance was robust and simple to operate. Freezing plasma samples in 10 studies and re-examining them weekly for six weeks showed no significant variation in results; hence reproducibility was good. This new and accurate method for determining the glomerular filtration rate merits further study and might find a useful place in routine clinical practice.
前瞻性分析了一种测定肾小球滤过率的新方法。该方法采用X射线荧光技术来测量注射的非离子型碘化造影剂在血浆中的清除情况。对87例患者进行了研究。54例静脉注射100ml碘海醇(欧乃派克),33例注射50ml碘海醇。同时测量了铬-51标记的依地酸(51Cr-EDTA)的清除率。在接受100ml碘海醇的患者中,与51Cr-EDTA清除率有极好的相关性(r = 0.90)。使用50ml碘海醇的相关性也良好(r = 0.85)。33例患者中肌酐清除率与51Cr-EDTA清除率之间的相关性不太令人满意(r = 0.69)。造影剂未出现不良反应。用于测量造影剂清除率的设备坚固且操作简单。在10项研究中冷冻血浆样本,并在六周内每周重新检测,结果显示无显著变化;因此重复性良好。这种测定肾小球滤过率的新的准确方法值得进一步研究,可能在常规临床实践中找到有用的应用。