<br>99mTc-DTPA和51Cr-EDTA连续输注法测量肾小球滤过率的比较,Journal of Nephrology

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99mTc-DTPA和51Cr-EDTA连续输注法测量肾小球滤过率的比较
Journal of Nephrology ( IF 2.7 ) Pub Date : 2023-04-24 , DOI: 10.1007/s40620-023-01612-0
Clara Balouzet ₁ , Arthur Michon-Colin _{2,

3} , Léa Dupont ₁ , Emmanuelle Vidal-Petiot _{2,

4,

5} , Caroline Prot-Bertoye _{3,

6} , Stéphanie Baron _{2,

3,

6} , Hamza Ayari _{2,

3,

7} , Raphaël Cohen _{2,

3} , Pascal Houillier _{2,

3,

6} , Corinne Smadja ₁ , Martin Flamant _{2,

4,

5} , Marie Courbebaisse _{2,

3}

Affiliation

背景

2018 年底， ⁵¹铬标记乙二胺四乙酸 ( ⁵¹ Cr-EDTA) 的生产被停止，51 Cr-EDTA 是一种经过验证且广泛使用的用于测量肾小球滤过率的放射性同位素示踪剂。 Technetium-99m-二亚乙基三胺五乙酸 ( ^99m Tc-DTPA) 已被验证可通过单次推注进行 GFR 测量，但该程序不适合细胞外室水合过多的患者。在这种情况下，需要推注，然后连续输注示踪剂。本研究的目的是评估^99m Tc-DTPA 输注方案是否可以替代⁵¹ Cr-EDTA 进行 GFR 测量。

方法

我们在 2019 年 2 月和 3 月期间进行了一项前瞻性单中心研究。所有转诊进行 GFR 测量的患者同时接受两种放射性示踪剂： ⁵¹ Cr-EDTA 和^99m Tc-DTPA 推注和连续输注通过相同的静脉途径同时给药。在四个半小时内，收集血浆和尿液样本以计算尿液和血浆清除率。

结果

纳入 22 名患者（平均年龄 63.4 ± 17.5 岁；68% 为男性）。 ⁵¹ Cr-EDTA 和^99m Tc-DTPA 的平均尿清除率分别为 52.4 ± 22.5 mL/min 和 52.8 ± 22.6 mL/min ( p = 0.47)，平均偏差为 0.39 ± 2.50 mL/min，准确度在100% 的 10% (95% CI 100; 100)，皮尔逊相关系数为 0.994。 ⁵¹ Cr-EDTA 和^99m Tc-DTPA 的平均血浆清除率分别为 54.8 ± 20.9 mL/min 和 54.4 ± 20.9 mL/min ( p = 0.61)，平均偏差为 − 0.43 ± 3.89 mL/min，准确度在 77% 的 10% 以内（95% CI 59；91），皮尔逊相关系数为 0.983。

结论

^99m Tc-DTPA 的尿液和血浆清除率可与输注方案一起用于测量 GFR。

图形概要

"点击查看英文标题和摘要"

Comparison of 99mTc-DTPA and 51Cr-EDTA for glomerular filtration rate measurement with the continuous infusion method

Background

In late 2018, the production of ⁵¹Chromium-labelled ethylenediamine tetra-acetic acid (⁵¹Cr-EDTA), a validated and widely used radio-isotopic tracer for measuring glomerular filtration rate, was halted. Technetium-99m-diethylenetriaminepentaacetic acid (^99mTc-DTPA) has been validated for GFR measurement with a single bolus injection, a procedure not suitable in patients with extracellular compartment hyperhydration. In such cases, a bolus followed by continuous infusion of the tracer is required. The aim of this study was to evaluate whether ^99mTc-DTPA with the infusion protocol can replace ⁵¹Cr-EDTA for GFR measurement.

Methods

We conducted a prospective single centre study during February and March 2019. All patients referred for GFR measurement received both radiotracers simultaneously: ⁵¹Cr-EDTA and ^99mTc-DTPA bolus and continuous infusion were administered concomitantly through the same intravenous route. Over four and a half hours, plasma and urine samples were collected to calculate urinary and plasma clearance.

Results

Twenty-two patients were included (mean age 63.4 ± 17.5 years; 68% men). Mean urinary clearance of ⁵¹Cr-EDTA and ^99mTc-DTPA was 52.4 ± 22.5 mL/min and 52.8 ± 22.6 mL/min, respectively (p = 0.47), with a mean bias of 0.39 ± 2.50 mL/min, an accuracy within 10% of 100% (95% CI 100; 100) and a Pearson correlation coefficient of 0.994. Mean plasma clearance of ⁵¹Cr-EDTA and ^99mTc-DTPA was 54.8 ± 20.9 mL/min and 54.4 ± 20.9 mL/min, respectively (p = 0.61), with a mean bias of − 0.43 ± 3.89 mL/min, an accuracy within 10% of 77% (95% CI 59; 91) and a Pearson correlation coefficient of 0.983.