De Santo N G, Anastasio P, Cirillo M, Santoro D, Spitali L, Mansi L, Celentano L, Capodicasa D, Cirillo E, Del Vecchio E, Pascale C, Capasso G
Nephrology, Second University of Naples, Italy.
Nephron. 1999 Feb;81(2):136-40. doi: 10.1159/000045268.
The work was devised to compare measurements of glomerular filtration rate (GFR) by technetium-99m-diethylenetriaminepentacetic acid (99mTc-DTPA) renogram to those by creatinine clearance (measured and predicted by Cockroft and Gault) and by inulin clearance. A total number of 65 individuals were enrolled: 15 healthy controls and 50 patients with renal disease. Compared to inulin clearance used as the gold standard, 99mTc-DTPA overestimated at low and underestimated at high GFRs. 99mTc-DTPA measurements were less precise than creatinine clearance except for individuals with GFR >100 ml/min x 1.73 m2. Measured creatinine clearance had the highest correlation coefficient with inulin clearance, 99mTc-DTPA clearance the lowest. In correlation analyses, 81.5% of the interindividual variability for measured creatinine clearance could be explained by true differences in inulin clearance; this value dropped to 59.1 and 57.4% for predicted creatinine clearance and 99mTc-DTPA, respectively. In patients with GFR <25 ml/min x 1.73 m2, all 99mTc-DTPA measurements were out of the 95% confidence interval for the inulin measurement. It can be inferred that 99mTc-DTPA clearance from the renogram is less precise than measured and predicted creatinine clearance.
这项研究旨在比较用锝-99m-二乙三胺五乙酸（99mTc-DTPA）肾图测量的肾小球滤过率（GFR）与用肌酐清除率（通过Cockroft和Gault公式测量和预测）及菊粉清除率测量的GFR。总共招募了65名个体：15名健康对照者和50名肾病患者。与作为金标准的菊粉清除率相比，99mTc-DTPA在低GFR时高估，在高GFR时低估。除了GFR>100 ml/min×1.73 m2的个体外，99mTc-DTPA测量的精度低于肌酐清除率。测量的肌酐清除率与菊粉清除率的相关系数最高，99mTc-DTPA清除率的相关系数最低。在相关性分析中，测量的肌酐清除率个体间变异性的81.5%可由菊粉清除率的真实差异解释；预测的肌酐清除率和99mTc-DTPA的这一数值分别降至59.1%和57.4%。在GFR<25 ml/min×1.73 m2的患者中，所有99mTc-DTPA测量值均超出菊粉测量的95%置信区间。可以推断，肾图的99mTc-DTPA清除率不如测量的和预测的肌酐清除率精确。
