中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2015, Vol. 37 ›› Issue (2): 171-178.doi: 10.3881/j.issn.1000-503X.2015.02.007

• 论著 • 上一篇    下一篇

碘海醇清除率在慢性肾脏病儿童肾功能评价方面的应用

王宝宝1, 武元1, 秦岩1, 弓孟春1, 石希敏2, 景红丽2, 李方2, 陈朝英3, 宋红梅4, 李雪梅1()   

  1. 1中国医学科学院 北京协和医学院 北京协和医院 肾内科
    2中国医学科学院 北京协和医学院 北京协和医院 核医学科
    4中国医学科学院 北京协和医学院 北京协和医院 儿科,北京 100730.
    3首都儿科研究所 附属儿童医院肾内科,北京 100020
  • 收稿日期:2014-08-25 出版日期:2015-02-28 发布日期:2015-05-01
  • 作者简介:

    通信作者:李雪梅 电话:010-69155058,电子邮件:lixmpumch@126.com

  • 基金资助:
    基金项目:北京市科学技术委员会资助项目(D131100004713007、D09050704310901)

Application of Plasma Clearance of Iohexol in Evaluating Renal Function in Chinese Children with Chronic Kidney Disease

Bao-bao WANG1, Yuan WU1, Yan QIN1, Meng-chun GONG1, Xi-min SHI2, Hong-li JING2, Fang LI2, Chao-ying CHEN3, Hong-mei SONG4, Xue-mei LI1()   

  1. 1Department of Nephrology,
    2Department of Nuclear Medicine,
    4Department of Pediatrics,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
    3Children’s Hospital Affiliated to Capital Institute of Pediatrics,Being 100020,China
  • Received:2014-08-25 Online:2015-02-28 Published:2015-05-01
  • Supported by:
    Supported by the Beijing Municipal Science and Technology Commision(D131100004713007,D09050704310901)

摘要: 目的评价碘海醇清除率评估慢性肾脏病儿童肾小球滤过率的准确性,评估单次采血法和干血滤纸片法在碘海醇清除率应用中的可行性。方法纳入慢性肾脏病儿童45例,同时进行锝99m-二乙烯三胺五乙酸(99mTc-DTPA)血浆清除率与碘海醇血浆清除率测定,评价两种方法测得的肾小球滤过率的相关性和一致性。分析碘海醇单次取血法及干血滤纸片法与碘海醇双次采血法的一致性。结果45例患儿均完成碘海醇血浆清除率测定。其中36例患儿同时完成99mTc-DTPA血浆清除率测定,13例患儿完成干血滤纸片碘海醇清除率测定。碘海醇血浆清除率与99mTc-DTPA血浆清除率具有较好的相关性和一致性(r=0.941,P<0.01),两者结果的差值较小,为(6.53±11.6)ml/(min·1.73 m2)。碘海醇单次取血法和干血滤纸片法测定的清除率与碘海醇双次取血血浆清除率均具有较好的相关性(r=0.958,r=0.950),差值分别为(4.26±9.06)ml/(min·1.73 m2)和(0.48±10.89)ml/(min·1.73 m2)。结论碘海醇血浆清除率是一种安全、可靠的评估慢性肾脏病儿童肾功能的方法,单次取血法与干血滤纸片法使碘海醇清除率测定更简便、可行。

关键词: 碘海醇清除率, 儿童, 慢性肾脏病, 肾小球滤过率

Abstract: ObjectiveTo evaluate the accuracy of plasma clearance of iohexol(PCio)for glomerular filtration rate(GFR)measurement in Chinese children with chronic kidney disease(CKD)and assess the feasibility of single-blood-sample method or dried capillary blood spots in determining the PCio.MethodsTotally 45 CKD children were included,in whom the 99mTechnetium-diethylenetriaminepentaacetic acid(99mTc-DTPA)plasma clearance and iohexol plasma clearance were simultaneously determined.Blood samples were obtained 2,4,and 5 hours after injection.In addition,we also evaluated the efficacy of single blood sample method and dried blood spots method in iohexol plasma clearance.ResultsForty-five CKD children completed the iohexol plasma clearance and thirty-six children completed the 99mTc-DTPA plasma clearance at the same time among them.Thirteen children finished the iohexol dried blood spot clearance.The correlation coefficient between 99mTc-DTPA plasma clearance and iohexol plasma clearance was 0.941 and the bias was(6.53±11.6)ml/(min·1.73 m2),and the intraclass correlation coefficient(ICC)was high(ICC=0.947).The correlation between iohexol single-sample plasma clearance and double samples was also strong(r=0.958),with the bias being(4.26±9.06)ml/(min·1.73 m2)and the ICC being 0.970.The iohexol clearance by dried blood spots showed a good correlation with the serum iohexol clearance(r=0.950),with the bias still being small [(0.48±10.89)ml/(min·1.73 m2)].ConclusionsIohexol plasma clearance has satisfactory agreement with 99mTc-DTPA plasma clearance and can be used as an ideal method to measure GFR in CKD children.The single-sample method and dried blood spots method make iohexol plasma clearance more convenient and practical.

Key words: iohexol plasma clearance, children, chronic kidney disease, glomerular filtration rate

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