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梗阻性尿路病:速尿试验及肾图曲线模式分析

Obstructive uropathy: frusemide test and analysis of renographic curve patterns.

作者信息

Probst P, Ackermann D, Noelpp U, Roesler H

出版信息

Nuklearmedizin. 1983 Jun;22(3):128-35.

PMID:6312428
Abstract

49 patients with clinically proven uropathy and 14 others suffering from nephropathy underwent quantitative 131I-OIHA renography, combined with a frusemide provocation test. In significant obstruction, diuresis reaction was typically less than 5% (predictive value of a positive test 76%). The renographic curves, derived from the renal cortex and from the pyelon were diverging, with the pelvic curve showing a continuous rise (predictive value of a positive test for the curve pattern analysis 92%). Non-obstructive dilatation of the urinary system was characterized by a high diuresis index (greater than 15%) (predictive value 82%). The curve pattern was plateau-like before and showed a converging course of cortical and pelvic activity spontaneously, at least after diuresis provocation (predictive value 75%). Nephropathy alone could exceptionally mimick both significant obstruction and non-obstructive dilatation. Qualitative renographic curve analysis combined with diuresis provocation renders a higher diagnostic yield regarding the dynamic state of questionable uropathy than either test alone.

摘要

49例临床确诊为尿路病的患者和另外14例肾病患者接受了定量¹³¹I-OIHA肾图检查,并结合速尿激发试验。在严重梗阻时,利尿反应通常小于5%(阳性试验的预测价值为76%)。源自肾皮质和肾盂的肾图曲线呈分离状,肾盂曲线呈持续上升(曲线模式分析阳性试验的预测价值为92%)。泌尿系统的非梗阻性扩张的特征是利尿指数高(大于15%)(预测价值为82%)。曲线模式之前呈平台状,至少在利尿激发后,皮质和肾盂活动呈自发汇聚过程(预测价值为75%)。单纯肾病极个别情况下可模拟严重梗阻和非梗阻性扩张。定性肾图曲线分析结合利尿激发试验对于可疑尿路病动态状态的诊断率高于单独任何一项检查。

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