99mTc-MAG3的肾清除率和肾外清除率：与代表所有肾小球滤过率水平患者的125I-OIH和51Cr-EDTA的比较

Renal and extrarenal clearance of 99mTc-MAG3: a comparison with 125I-OIH and 51Cr-EDTA in patients representing all levels of glomerular filtration rate.

作者信息

Rehling M, Nielsen B V, Pedersen E B, Nielsen L E, Hansen H E, Bacher T

机构信息

Department of Clinical Physiology and Nuclear Medicine, Skejby University Hospital, Aarhus, Denmark.

出版信息

Eur J Nucl Med. 1995 Dec;22(12):1379-84. doi: 10.1007/BF01791145.

DOI:10.1007/BF01791145

PMID:8586082

Abstract

. This investigation was undertaken in order to determine whether the clearance of technetium-99m mercaptoacetyltriglycine (99mTc-MAG3) is more closely correlated to the clearance of iodine-125 orthoiodohippurate (125I-OIH) than to the clearance of chromium-51 ethylene diamine tetra-acetate (51Cr-EDTA) and whether there is a clinically significant extrarenal clearance of 99mTc-MAG3 . Fifty-one patients with a glomerular filtration rate (GFR) of 4-132ml/min were studied. After a simultaneous single injection of the three tracers, plasma clearance was measured from blood samples 0-5h post injection (p.i.) (0-24h in patients with GFR<15ml/min). Renal plasma clearance was measured 0-5h p.i. The ratio between the renal plasma clearance of 99mTc-MAG3 and 125I-OIH was 0.57. The ratio between the renal plasma clearance of 99mTc-MAG3 and 51Cr-EDTA was 2.57. The coefficient of variation (CV) of the 99mTc-MAG3/125I-OIH ratio was significantly smaller than the CV of the 99mTc-MAG3/51Cr-EDTA ratio (13.4% versus 31.2%). The corresponding plasma clearance ratios were 0.59 (CV=14.8%) and 2.48 (CV=27.0%). Plasma clearance overestimated renal plasma clearance by 7.0ml/min (5.4%) for 99mTc-MAG3 and by 4.1ml/min (8.4%) for 51Cr-EDTA. The difference in plasma and renal plasma clearance of 125I-OIH of 5.5ml/min did not reach statistical significance. Red blood cell binding of 99mTc-MAG3, 125I-OIH and 51Cr-EDTA was 2.0%, 14.6% and 0.2%, respectively. Protein binding of 99mTc-MAG3, 125I-OIH and 51Cr-EDTA was 86.3%, 61.1% and 5.9%, respectively. The volume of distribution of 99mTc-MAG3, 125I-OIH and 51Cr-EDTA was 16.3%, 27.0% and 19.4% of body weight. In conclusion, the clearances of 99mTc-MAG3 and 125I-OIH are more closely correlated than is the clearance of 99mTc-MAG3 with GFR. Extrarenal clearance of 99mTc-MAG3 is relatively smaller than extrarenal clearance of 51Cr-EDTA. Thus, plasma clearance of 99mTc-MAG3 can be used as a measure of renal tubular function.

摘要

本研究旨在确定锝-99m 巯基乙酰三甘氨酸（99mTc-MAG3）的清除率与碘-125 邻碘马尿酸（125I-OIH）的清除率之间的相关性是否比与铬-51 乙二胺四乙酸（51Cr-EDTA）的清除率更密切，以及 99mTc-MAG3 是否存在具有临床意义的肾外清除。对 51 例肾小球滤过率（GFR）为 4 - 132ml/min 的患者进行了研究。在同时单次注射这三种示踪剂后，于注射后 0 - 5 小时（GFR<15ml/min 的患者为 0 - 24 小时）从血样中测量血浆清除率。在注射后 0 - 5 小时测量肾血浆清除率。99mTc-MAG3 与 125I-OIH 的肾血浆清除率之比为 0.57。99mTc-MAG3 与 51Cr-EDTA 的肾血浆清除率之比为 2.57。99mTc-MAG3/125I-OIH 比值的变异系数（CV）显著小于 99mTc-MAG3/51Cr-EDTA 比值的 CV（13.4% 对 31.2%）。相应的血浆清除率之比为 0.59（CV = 14.8%）和 2.48（CV = 27.0%）。99mTc-MAG3 的血浆清除率比肾血浆清除率高估了 7.0ml/min（5.4%），51Cr-EDTA 高估了 4.1ml/min（8.4%）。125I-OIH 的血浆清除率与肾血浆清除率相差 5.5ml/min，未达到统计学显著性。99mTc-MAG3、125I-OIH 和 51Cr-EDTA 与红细胞的结合率分别为 2.0%、14.6% 和 0.2%。99mTc-MAG3、125I-OIH 和 51Cr-EDTA 与蛋白质的结合率分别为 86.3%、61.1% 和 5.9%。99mTc-MAG3、125I-OIH 和 51Cr-EDTA 的分布容积分别为体重的 16.3%、27.0% 和 19.4%。总之，99mTc-MAG3 与 125I-OIH 的清除率之间的相关性比 99mTc-MAG3 与 GFR 的清除率之间的相关性更密切。99mTc-MAG3 的肾外清除相对小于 51Cr-EDTA 的肾外清除。因此，99mTc-MAG3 的血浆清除率可作为肾小管功能的一项指标。