Galli G, Rufini V, Meduri G, Piraccini R, D'Andrea G
Institute of Nuclear Medicine, Catholic University, Sacro Cuore, Rome, Italy.
J Nucl Biol Med (1991). 1994 Dec;38(4):556-65.
In order to assess the practical reliability of glomerular filtration rate (GFR) determination with 99mTc-DTPA and plasma sampling, the authors compared the results obtained with 51Cr-EDTA and 99mTc-DTPA in 50 patients using five easily applied methods (two double-plasma-sample methods and three single-plasma-sample methods), and two kits with different compositions. It was observed that: 1) there is no difference between the results obtained with the two different kits. 2) Compared with 51Cr-EDTA the 99mTc-DTPA overestimates the result by about 2 mL/min: precision is slightly lower with 99mTc-DTPA than with 51Cr-EDTA but is sufficient for practical use. 3) The method recommended by the authors on the basis of this experience is the Russell's method with two samples. 4) The simplified methods with one sample give comparable results to the Russell's method for GFR levels between 50 and 115 mL/min, while the results are unsatisfactory below 50 mL/min. 5) Among the single-sample methods, the authors suggest that of Christensen and Groth. 6) A preliminary estimate of GFR (from the serum creatinine level, for instance) is useful for the choice between double-plasma-sample methods and simplified methods. In conclusion, the authors consider that the estimation of GFR with 99mTc-DTPA can be performed efficiently in clinical practice even when operating in absolutely routine conditions.
为评估采用99mTc - DTPA测定肾小球滤过率（GFR）及血浆采样的实际可靠性，作者使用五种易于应用的方法（两种双血浆样本法和三种单血浆样本法）以及两种不同成分的试剂盒，对50例患者采用51Cr - EDTA和99mTc - DTPA所获结果进行了比较。观察到：1）两种不同试剂盒所获结果无差异。2）与51Cr - EDTA相比，99mTc - DTPA使结果高估约2 mL/min：99mTc - DTPA的精密度略低于51Cr - EDTA，但足以满足实际应用。3）作者基于此经验推荐的方法是双样本的罗素法。4）对于GFR在50至115 mL/min之间的情况，单样本简化方法所获结果与罗素法相当，而在低于50 mL/min时结果不令人满意。5）在单样本方法中，作者推荐克里斯滕森和格罗思的方法。6）GFR的初步估计（例如根据血清肌酐水平）对于在双血浆样本法和简化方法之间进行选择很有用。总之，作者认为即使在绝对常规条件下操作，采用99mTc - DTPA估计GFR在临床实践中也能有效进行。
