閉塞性腎疾患に関する臨床的検討 第2報 : 閉塞腎の機能と99mTc-Dimercaptosuccinic Acid (DMSA)腎摂取率の関係について

Abstract

閉塞腎の99mTc-DMSA摂取率がその腎機能を正確に反映するかどうかを検討するため, 腎血流量の指標として閉塞腎の131I-hippuran摂取率(静注後1～2分間), 糸球体濾過値の指標として閉塞解除直後の分腎クレアチニンクリアランスを測定し99mTc-DMSA腎摂取率との相関性を検討した.99mTc-DMSA腎摂取率と131I-hippuran腎摂取率の間にはきわめて良好な相関性が認められ(r=0.8809, p<0.001), 99mTc-DMSA腎摂取率は閉塞腎の腎血流量の定量的指標として臨床的に利用しえるものと考えた.99mTc-DMSA腎摂取率とクレアチニンクリアランスの間にも有意の相関が認められたが(r=0.7876, p<0.001), 後者は前者より低値をとる傾向が認められた

To establish a method of detecting divided renal function of the obstructed kidneys noninvasively, comparative studies on 99mTc -DMSA uptake (60 minutes after injection), I 131-hippuran renal uptake (1-2 minutes after injection) and divided creatinine clearance immediately after relief of urinary obstruction were made on 24 cases of obstructive uropathy. A close significant correlation was obtained between 99mTc -DMSA and I 131-hippuran renal uptakes (gamma = 0.8809, P less than 0.001). Also, a significant correlation was noted between 99mTc -DMSA renal uptake and divided creatinine clearance (gamma = 0.7876, P less than 0.001), but the latter constantly gave lower values than the former. These observations led us to conclude that 99mTc -DMSA renal uptake is a reliable indicator of the renal plasma flow in the obstructed kidneys. Quantitative divided renal function of the obstructed kidneys can be estimated by the 99mTc -DMSA uptake method.