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在患有后尿道的儿童中,估计和测量的淋巴膜过率进行比较
Manish Ora1, Lokeshwaran Madurai Kalimuthu1, Prabhakar Mishra2
1Department of Nuclear Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India.
Journal of Indian Association of Pediatric Surgeons
|August 28, 2023
概括
后尿道 (PUV) 可以导致儿童脏疾病. 测量GFR (mGFR) 比估计GFR (eGFR) 方法更可靠,用于评估这些患者的功能.
科学领域:
- 儿科脏病学 儿科脏病学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 诊断医学 诊断医学 诊断医学
背景情况:
- 后尿道 (PUV) 是儿童阻塞性尿路病的主要原因,可能导致慢性病 (CKD) 和末期病 (ESRD).
- 淋巴膜过率 (GFR) 是评估功能的黄金标准,但其直接测量往往是不切实际的.
- 使用内源性过标志物的估计GFR (eGFR) 方法是常用的,但可能是不准确的,在儿童PUV患者由于诸如增长迟缓影响肌素的生产等因素.
研究的目的:
- 为了比较测量的GFR (mGFR) 与各种基于肌素的估计GFR (eGFR) 方法,在患有PUV的儿科患者中.
- 评估不同的eGFR方程在该特定人群中对CKD等级的分类中的准确性.
主要方法:
- 这是一项对62名儿科患者进行的回顾性研究,他们接受了PUV后充血治疗.
- 使用99mTc-diethylenetriaminepentaacetate (DTPA) 体外 方法确定了mGFR.
- 八个eGFR方程 (Schwartz,Cockcroft-Gault [CG],Counahan-Barratt [CB],CKD-EPI,全年光谱[FAS]年龄,FAS高度[FAS Ht],Schwartz-Lyon [SL]和高度独立) 与mGFR和CKD等级进行了比较.
主要成果:
- 在mGFR和eGFR值之间观察到显著的正相关性 (0.46-0.77).
- eGFR方法在分类CKD等级方面显示出可变的准确性,正确分类率从25.8%到51.6%不等.
- 在较低的水平上,eGFR倾向于高估GFR,在较高的水平上低估它.
结论:
- 基于肌素的eGFR方法具有相当大的局限性,并且不应该完全取代儿科PUV患者的mGFR测量.
- 建议进行初始的mGFR测量,然后进行串行eGFR监测.
- 对于某些CKD等级,特定的eGFR方程显示出更高的准确性:II级的CB,III级的SL或高度独立,IV级的FAS年龄,V级的SL.
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