Objective:To investigate the effect of different kidney depth estimation formulas modified using SPECT/CT renal dynamic imaging on the calculation of the glomerular filtration rate (GFR) in living kidney transplant donors.Methods:The clinical data of 127 healthy kidney transplant donors who underwent preoperative 99Tc m-diethylene triamine pentoacetic acid (DTPA) renal dynamic imaging in the First Affiliated Hospital of Xi'an Jiaotong University from October 2011 to December 2017 were retrospectively analyzed. Included 36 males and 91 females, aged (49.2±7.3) years. The computed GFR of kidney depth measured via CT was adopted as the standard reference standard. The T?nnesen and Itoh formulas were used to calculate kidney depth and the corresponding GFR and then compare them with the CT results. The measurement data that did not conform to the normal distribution were expressed as M ( Q1, Q2), and the Wilcoxon rank sum test was used to compare between the renal depth calculated by each formula. Spearman correlation analysis and linear regression analysis were used to analyze the correlation between renal depth and the corresponding GFR of lelf and right kidney by each formula. Results:The depth of the left and right kidneys from 127 healthy kidney transplant donors measured via CT [7.03(6.34, 7.67) cm, 7.21(6.51, 8.13) cm] was significantly higher than those obtained using the T?nnesen formula [5.66(5.30, 6.06) cm, 5.70(5.33, 6.10) cm] and the Itoh formula [6.70(6.33, 7.10) cm, 6.88(6.52, 7.26) cm], and the differences were statistically significant (left kidney: Z=-9.53, -3.77, both P<0.001; right kidney: Z=-9.73, -4.64, both P<0.001). The renal depth measured via CT was positively correlated with the renal depth calculated using the T?nnesen and Itoh formulas (left kidney: r=0.330, 0.331, both P<0.001; right kidney: r=0.359, 0.358, both P<0.001). The GFR of left and right kidneys that corresponded to the renal depth measured via CT [46.4(39.9, 52.0) ml/min, 46.0(40.5, 54.9) ml/min] was higher than those obtained using the T?nnesen formula [36.6(33.0, 41.9) ml/min, 36.2(32.1, 40.1) ml/min] and the Itoh formula [43.2 (39.4, 49.8) ml/min, 43.8 (39.4, 48.7) ml/min], and the differences were statistically significant (left kidney: Z=-9.52, -3.76, both P<0.001; right kidney: Z=-9.73, -4.75, both P<0.001). The CT measurement was positively correlated with the GFR values that corresponded to kidney depth estimates obtained using the T?nnesen and Itoh formulas (left kidney: r=0.476, 0.476, both P<0.001; right kidney: r=0.386, 0.539, both P<0.001). Conclusions:The GFR calculated using the T?nnesen and Itoh formulas are suitable for the routine screening and evaluation of kidney diseases. For kidney transplant donors with more stringent requirements for renal GFR, kidney depth measured via CT should be used to correct the GFR calculated using SPECT/CT.

目的 探讨高质量弹丸注射对Gates法准确测定活体肾移植供者GFR的重要意义.方法 收集在我院核医学科行肾动态显像的102例亲属活体肾移植供者的检查资料,将这102例受检者根据弹丸注射质量分为两组:A组(弹丸注射质量良好)56例,B组(弹丸注射质量欠佳以及不合格)46例.对比两组的年龄、性别、肾脏深度、注入体内放射性计数、分肾GFR、总肾GFR、eGFR差异,并将两组的肾动态显像测定的总肾GFR值与eGFR进行相关性和一致性分析.结果 A、B两组的年龄、性别、肾脏深度、注入体内放射性计数、eGFR差异均无统计学意义,而两组的左肾GFR、右肾GFR、总GFR的差异均具有统计学意义.与B组相比,A组的总GFR与eGRF有更好的相关性和一致性.结论 高质量弹丸注射对Gates法准确测定活体肾移植供者GFR具有重要意义,弹丸质量不佳将导致测定的GFR偏低.

目的 寻求不同免疫检测系统测定育龄期妇女促甲状腺激素(TSH)结果差异的原因,提高在该人群TSH检测结果的一致性及准确性.方法 分别用罗氏电化学发光法(A)和Cisbio Bioassays(B)、Diasource(无阻断剂)(C)、潍坊3V(D)、Diasource(有阻断剂)(E)免疫放射分析法对育龄期妇女血清进行检测,比较各种方法检测TSH结果的一致性及差异性,并采用HCG交叉实验及质谱检测对差异原因进行分析.结果 ①A、B、C、D对育龄期妇女血清TSH检测结果一致性为94.1％;少数育龄期妇女A、B、D、E检测结果基本一致,与C完全相反;②HCG不是导致A、B、D、E与C对少数育龄期妇女TSH检测结果差异显著的原因;③阻断剂是导致A、B、D、E与C对少数育龄期妇女TSH检测结果差异显著的原因.结论 阻断剂的添加可以消除各种检测方法间的差异,提高TSH准确性.