Objective To investigate the diagnostic value of 99mTc-DTPA nuclide renal dynamic imaging in early renal damage in elderly essential hypertension(EH). Methods Among the elderly patients with essential hypertension who were enrolled in our hospital. 86 patients were enrolled as the study subjects. They were divided into two groups according to the results of 24-hour urinary microalbuminuria(MA):MA negative(A) group and MA posistive(B) group.Meanwhile,20 elderly healthy persons were selected as the control group. 99mTc-DTPA re-nal dynamic imaging was performed in all subjects to detect couple glomerular filtration rate(GFR),the peak time(TP),half emptying time(T1/2) and ration of 20 min and peak phase kidney radioactivity count(T20/P%).At the same time,MA,serum cystatin C(Cys-C),surem creatinine(SCr) and blood urea nitrogen(BUN) were de-tected and compared with three groups. Rusults(1)The positive rate of early renal damage with 99mTc-DTPA nu-clide renal dynamic imaging method was significantly higher than those of two later methods(P < 0.01).(2)The levels of GFR,TP,T1/2,and T20/P% in group A were significantly higher than those in the control group and those in group B significantly higher than those in group A(P<0.05).(3)The levels of MA and Cys-C in group A was sig-nificantly higher than that of the control group,and those in group B significantly higher than that of group A(P<0.05).In comparisons of SCr and BUN among the three groups,the results had no significant difference. Conclu-sion 99mTc-DTPA nuclide renal dynamic imaging can early detect the renal damage in elderly EH patients,and it has better clinical value.%目的 探讨99mTc二乙三胺五醋酸(99mTc-DTPA)肾动态显像对老年原发性高血压(EH)早期肾损害的诊断价值.方法 选择我院老年病科老年EH患者86例为研究对象,同期正常老年体检者20例为对照组.入选者行99mTc-DTPA肾动态显像测定肾小球滤过率(GFR),同时记录双肾的峰值、高峰时间(Tp)、半排时间(T1/2)、20 min残留率(T20/P%),检测同期24 h尿微量白蛋白(MA)、血清光抑素-C(Cys-C)、血肌苷(SCr)、尿素氮(BUN),并将研究对象分成MA阴性组(A组)、阳性组(B组).结果(1)99mTc-DTPA肾动态显像测得EH早期肾损害的阳性率显著高于MA和Cys-C检测的阳性率(P<0.01).(2)3组测得GFR、Tp、T1/2、T20/P%值分析,A组与对照组、B组与A组比较差异均有显著性(P<0.05).(3)3组MA、Cys-C比较,A显著高于对照组,B组显著高于A组(P<0.05),3组SCr、BUN比较差异无显著性(P>0.05).结论99mTc-DTPA肾动态显像可发现老年EH早期肾损害,对老年EH早期肾功能检测有较好的应用价值.
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