利用皮下注射51Cr-乙二胺四乙酸评估肾小球滤过率。

Assessment of glomerular filtration rate utilizing subcutaneously injected 51Cr-EDTA.

Monteiro M C, Alonso G, Ajzen H, Pereira A B

Disciplinas de Nefrologia e Medicina Nuclear, Escola Paulista de Medicina, São Paulo, Brasil.

Braz J Med Biol Res. 1994 Nov;27(11):2557-64.

Abstract

51Cr-EDTA injected with lidocaine and epinephrine, as a subcutaneous button, is slowly absorbed, and a plasma level that is relatively stable can be maintained for a time sufficient to permit measurement of the renal clearance of EDTA, which is a measure of glomerular filtration rate (GFR). We studied this procedure in 32 normal volunteers and 24 patients with different glomerulopathies, comparing EDTA and creatinine clearances. In 20 patients these measurements were also compared with inulin clearance. 2. Creatinine clearance overestimates GFR due to tubular secretion of creatinine. This secretion is present even in patients with significantly reduced glomerular filtration rates. As a consequence, the lower the GFR the higher the overestimation will be. 3. A good correlation was obtained between the 51Cr-EDTA and inulin clearance: y(EDTA) = 4.21 + 0.88 x (inulin), r = 0.98. The procedure is simple to perform, and the radiotracer utilized is significantly less expensive than iothalamate.

摘要

将51Cr - EDTA与利多卡因和肾上腺素一起作为皮下纽扣注射，其吸收缓慢，可在足够长的时间内维持相对稳定的血浆水平，以允许测量EDTA的肾清除率，而这是肾小球滤过率（GFR）的一种测量方法。我们在32名正常志愿者和24名患有不同肾小球疾病的患者中研究了该方法，比较了EDTA清除率和肌酐清除率。在20名患者中，还将这些测量结果与菊粉清除率进行了比较。2. 由于肌酐的肾小管分泌，肌酐清除率会高估GFR。即使在肾小球滤过率显著降低的患者中也存在这种分泌。因此，GFR越低，高估程度就越高。3. 51Cr - EDTA清除率与菊粉清除率之间存在良好的相关性：y(EDTA)=4.21 + 0.88x(菊粉)，r = 0.98。该方法操作简单，且所使用的放射性示踪剂比碘他拉酸盐便宜得多。