Upsdell S M, Leeson S M, Brooman P J, O'Reilly P H
Department of Urology, Stepping Hill Hospital, Stockport.
Br J Urol. 1988 Jan;61(1):14-8. doi: 10.1111/j.1464-410x.1988.tb09154.x.
Minute-by-minute urinary flow rates before and after the intravenous injection of 40 mg frusemide were investigated in 29 well hydrated adult patients with varying creatinine clearances. Total urinary flow rates 3 to 6 min after frusemide ranged from 1 to 42 ml/min (mean 19). At 15 to 18 min after the diuretic, flow rates ranged from 8 to 46 ml/min (mean 23). Flow rates were proportional to creatinine clearance (r = 0.73; r = 0.8) and decreased with falling clearance, although significant diuresis (4 ml/min/kidney) was achieved down to single kidney clearances of 10 ml/min. Where single kidney clearances were less than 31 ml/min, single kidney flow rates of 10 ml/min or more were not guaranteed. Below this clearance, diuresis renography remains completely reliable and unequivocal in the majority of cases. However, perfusion pressure flow studies will not necessarily be urodynamically comparable and it should not be expected that the results of the two tests will agree in individual cases of upper tract dilatation. Recommended timing for frusemide administration should be 20 min into the test, or 15 min before radiopharmaceutical injection.
对29例肌酐清除率各异但水分充足的成年患者，研究了静脉注射40毫克速尿前后每分钟的尿流率。速尿注射后3至6分钟的总尿流率为1至42毫升/分钟（平均19）。利尿剂注射后15至18分钟，尿流率为8至46毫升/分钟（平均23）。尿流率与肌酐清除率成正比（r = 0.73；r = 0.8），并随清除率下降而降低，尽管在单肾清除率低至10毫升/分钟时仍可实现显著利尿（4毫升/分钟/肾）。当单肾清除率低于31毫升/分钟时，无法保证单肾尿流率达到10毫升/分钟或更高。低于此清除率时，利尿肾图在大多数情况下仍完全可靠且明确。然而，灌注压力流研究不一定在尿动力学上具有可比性，不应期望这两项检查的结果在个别上尿路扩张病例中一致。推荐的速尿给药时间应为检查开始后20分钟，或在放射性药物注射前15分钟。
