Bakir A A, Lopez-Majano V, Hryhorczuk D O, Rhee H L, Dunea G
Am J Med. 1985 Aug;79(2):175-82. doi: 10.1016/0002-9343(85)90007-5.
To assess the activity of lupus nephritis, 43 patients with systemic lupus erythematosus (SLE) were studied by gallium imaging. Delayed renal visualization 48 hours after the gallium injection, a positive result, was noted in 25 of 48 scans. Active renal disease was defined by the presence of hematuria, pyuria (10 or more red blood cells or white blood cells per high-power field), proteinuria (1 g or more per 24 hours), a rising serum creatinine level, or a recent biopsy specimen showing proliferative and/or necrotizing lesions involving more than 20 percent of glomeruli. Renal disease was active in 18 instances, inactive in 23, and undetermined in seven (a total of 48 scans). Sixteen of the 18 scans (89 percent) in patients with active renal disease showed positive findings, as compared with only four of 23 scans (17 percent) in patients with inactive renal disease (p less than 0.001). Patients with positive scanning results had a higher rate of hypertension (p = 0.02), nephrotic proteinuria (p = 0.01), and progressive renal failure (p = 0.02). Mild mesangial nephritis (World Health Organization classes I and II) was noted only in the patients with negative scanning results (p = 0.02) who, however, showed a higher incidence of severe extrarenal SLE (p = 0.04). It is concluded that gallium imaging is a useful tool in evaluating the activity of lupus nephritis.
为评估狼疮性肾炎的活动情况，对43例系统性红斑狼疮（SLE）患者进行了镓显像研究。在48次扫描中，有25次在注射镓48小时后出现肾脏延迟显影，这是一个阳性结果。活动性肾脏疾病的定义为存在血尿、脓尿（每高倍视野10个或更多红细胞或白细胞）、蛋白尿（每24小时1g或更多）、血清肌酐水平升高，或近期活检标本显示超过20%的肾小球有增殖性和/或坏死性病变。肾脏疾病在18例中为活动期，23例为非活动期，7例未确定（共48次扫描）。活动性肾脏疾病患者的18次扫描中有16次（占89%）显示阳性结果，而非活动性肾脏疾病患者的23次扫描中只有4次（占17%）显示阳性结果（p<0.001）。扫描结果为阳性的患者高血压发生率更高（p = 0.02）、肾病性蛋白尿发生率更高（p = 0.01）以及进行性肾衰竭发生率更高（p = 0.02）。轻度系膜增生性肾炎（世界卫生组织I级和II级）仅在扫描结果为阴性的患者中出现（p = 0.02），不过这些患者严重肾外SLE的发生率更高（p = 0.04）。结论是镓显像在评估狼疮性肾炎的活动情况方面是一种有用的工具。
