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目的 分析慢性梗阻性肾积水患者利尿肾动态显像参数与肾功能指标的相关性，为临床早期诊断、干预提供参考。方法 选取2020年8月至2025年2月安徽理工大学第一附属医院及淮南东方集团总院收治的96例慢性梗阻性肾积水患者，根据不同积水程度分为轻度积水组、中度积水组、重度积水组，根据不同肾损伤程度分为轻度肾损伤组、中度肾损伤组、重度肾损伤组。分别比较不同积水程度、不同肾损伤程度利尿肾动态显像参数[肾小球滤过率（GFR）、半排时间、利尿排泄指数（DEI）]、肾功能指标[血尿素氮（BUN）、血清肌酐（SCr）、胱抑素C(Cys C)]，分析利尿肾动态显像参数与肾功能指标、积水程度及肾损伤程度的相关性，并分析利尿肾动态显像参数、肾功能指标对肾损伤的评估价值。结果 轻度积水组GFR、DEI均高于中度积水组、重度积水组，半排时间低于中度积水组、重度积水组（P<0.05）；轻度积水组BUN、SCr、Cys C均低于中度积水组、重度积水组（P<0.05）；轻度肾损伤组GFR、DEI均高于中度肾损伤组、重度肾损伤组，半排时间低于中度肾损伤组、重度肾损伤组（P<0.05）；轻度肾损伤组BUN、SCr、Cys C均低于中度肾损伤组、重度肾损伤组（P<0.05）;GFR、DEI与BUN、SCr、Cys C均呈负相关，半排时间与BUN、SCr、Cys C呈正相关（P<0.05）,GFR、DEI与积水程度、肾损伤程度均呈负相关，半排时间与积水程度、肾损伤程度均呈正相关（P<0.05）;GFR、半排时间、DEI、BUN、SCr、Cys C联合评估慢性梗阻性肾积水患者重度肾损伤的曲线下面积（AUC）为0.943(95%CI:0.876～0.980,P<0.05)。结论 慢性梗阻性肾积水患者利尿肾动态显像所测得GFR、半排时间、DEI与肾功能指标BUN、SCr、Cys C有显著相关性，联合检测有利于提高肾损伤评估效能。
Abstract：Objective To analyze the correlation between diuretic renography parameters and kidney function tests in patients with chronic obstructive hydronephrosis, providing a reference for early clinical diagnosis and intervention. Methods A total of 96 patients with chronic obstructive hydronephrosis admitted to the First Affiliated Hospital of Anhui University of Science and Technology and Huainan Oriental Group General Hospital from August 2020 to February 2025 were selected. Patients were stratified into mild, moderate, and severe groups based on the degree of hydronephrosis and the severity of renal impairment, respectively. Diuretic renography parameters [Glomerular Filtration Rate(GFR), Half-clearance time(T1/2), Diuretic Excretion Index(DEI)] and kidney function tests [Blood Urea Nitrogen(BUN), Serum Creatinine(SCr), Cystatin C(Cys C)] were compared across groups. Correlations between diuretic renography parameters, kidney function tests, hydronephrosis severity, and renal impairment severity were analyzed. The evaluation value of diuretic renography parameters and kidney function tests for renal impairment was assessed. Results GFR and DEI in the mild hydronephrosis group were significantly higher than those in the moderate and severe groups, while T1/2 was lower(P<0.05). BUN, SCr, and Cys C levels in the mild hydronephrosis group were significantly lower than those in the moderate and severe groups(P<0.05). Similar trends were observed across the renal impairment severity groups(P<0.05). GFR and DEI were negatively correlated with BUN, SCr, and Cys C, whereas T1/2 was positively correlated with these markers(P<0.05). GFR and DEI were negatively correlated with the severity of hydronephrosis and renal impairment, while T1/2 was positively correlated(P<0.05). The combined Area Under the Curve(AUC) of GFR, T1/2, DEI, BUN, SCr, and Cys C for evaluating severe renal impairment in patients with chronic obstructive hydronephrosis was 0.943(95%CI:0.876-0.980,P<0.05). Conclusion In patients with chronic obstructive hydronephrosis, diuretic renography parameters(GFR, T1/2, DEI) are significantly correlated with kidney function tests(BUN, SCr, Cys C). Combined detection of these parameters improves the efficacy of renal impairment evaluation.
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基本信息:
DOI：10.19558/j.cnki.10-1020/r.2026.01.004
中图分类号:R692.2
引用信息:
[1]王崇英,席泽,姚国玲.慢性梗阻性肾积水患者利尿肾动态显像参数与肾功能指标的相关性分析[J].微创泌尿外科杂志,2026,15(01):16-22.DOI:10.19558/j.cnki.10-1020/r.2026.01.004.
基金信息:
安徽省卫生厅医药科研计划项目（11367KJ20220591）
2025-05-22
2025
2026-03-02
2026
2026-03-05
1
2026-02-28
2026-02-28