Brough R J, Lancashire M J, Prince J R, Rose M R, Prescott M C, Payne S R, Testa H J
Department of Urology, Withington Hospital, Manchester, UK.
Eur J Nucl Med. 1998 Nov;25(11):1520-3. doi: 10.1007/s002590050330.
Diclofenac (a non-steroidal anti-inflammatory drug) and pethidine (a synthetic opiate) are the two analgesics most commonly used to relieve the pain of ureteric colic. Fast frame renography is a non-invasive means of imaging ureteric peristalsis and renal drainage. The aim of this study was to determine the effects of each of these drugs on the drainage pattern of the upper tracts. Twelve normal male volunteers were studied. All underwent a standard fast frame renogram using 75 MBq of technetium-99m-mercaptoacetyltriglycine, and were then administered either 100 mg pethidine or 75 mg diclofenac by intramuscular injection. Fast frame renography was then repeated. Peristalsis was determined from the condensed image of each ureter and the renogram curves were analysed to obtain standard parameters and deconvolution analysis. Diclofenac caused a profound disruption to both ureteric peristalsis and the renogram curve. This effect was not seen after the administration of pethidine. Deconvolution analysis suggests the effects of diclofenac are mediated via a direct effect on drainage rather than by any alteration of blood flow to the kidney. This study suggests that pethidine is the analgesic of choice prior to renography and that inferences about alterations of drainage in the presence of diclofenac should be interpreted with care.
双氯芬酸（一种非甾体抗炎药）和哌替啶（一种合成阿片类药物）是最常用于缓解输尿管绞痛的两种镇痛药。快速帧肾图是一种用于成像输尿管蠕动和肾脏引流的非侵入性方法。本研究的目的是确定这两种药物各自对泌尿系统上半部分引流模式的影响。对12名正常男性志愿者进行了研究。所有人都使用75MBq的锝-99m-巯基乙酰三甘氨酸进行了标准的快速帧肾图检查，然后通过肌肉注射给予100mg哌替啶或75mg双氯芬酸。随后重复进行快速帧肾图检查。从每条输尿管的浓缩图像确定蠕动情况，并分析肾图曲线以获得标准参数和解卷积分析结果。双氯芬酸对输尿管蠕动和肾图曲线均造成了严重破坏。给予哌替啶后未观察到这种效应。解卷积分析表明，双氯芬酸的作用是通过对引流的直接影响介导的，而不是通过对肾脏血流的任何改变。本研究表明，哌替啶是肾图检查前的首选镇痛药，并且在存在双氯芬酸的情况下对引流改变的推断应谨慎解释。
