The Research On The Evaluation Of Renal Function Of Malignant Tumor Patients Undergoing Chemotherapy

Objective To explore the influence of renal function of maligant tumor patients undergoing chemotherapy by99mTc-DTPA renal dynamic imaging,and then to adjust the chemotherapy plan,providing the reference for individual therapy.Methods34lung cancer patients with chemotherapy including cisplatin in oncology department of our hospital and27breast cancer patients with chemotherapy not including cisplain are all undergoing99mTc-DTPA renal dynamic imaging before the first chemotherapy,after1cycle and2cycle chemotherapy. And comparing the results of BUN and SCr testing at the same time.Rule out the kidney disease history of the patients.Through analyzing the results renal dynamic imaging,to evaluate the differences of renal function between patients before chemotherapy and after chemotherapy. Matched-pairs t-test and independent-sample t-test were used to compare the results before chemotherapy and after chemotherapy of patients of two groups, and u-test is used to compare the rates.Results Renal dynamic imaging quantitative index results of lung cancer patients show that:the tb of left and right kidney before chemotherapy is9.55±1.90s,9.65±2.62s, is11.00±2.15s、12.52±2.35s after1cycle chemotherapy, is11.76±2.55s、13.20±2.76s after2cycle chemotherapy,the tb before chemotherapy is defferent from that after1cycle chemotherapy and2cycle chemotherapy, t=2.561,2.648,2.678,2.748, p<0.05; C1/2of left and right kidney before Chemotherapy is11.40±2.83min,11.97±3.00min, and is15.27±4.84min,14.71±4.65min after2cycle chemotherapy, the differences of C1/2between before chemotherapy and after2cycle chemotherapy is notable, t=3.904and3.072, p<0.01;The bilateral renal GFR before chemotherapy were50.03±8.72ml/min,50.60±7.47ml/min, and is not different from that after1cycle chemotherapy, t=0.153、0.176, p>0.05, the GFR of left and right kidney is45.33±11.11ml/min、46.42 ±10.16ml/min after2cycle chemotherapy, and is different notably from that before chemotherapy, t=2.062、2.957, p<0.05.Renal dynamic imaging quantitative index results of breast cancer patients show that:C1/2of left and right kidney before chemotherapy is10.97±2.18min11.14±2.35min,and is13.69±3.13min13.32±2.86after2cycle chemotherapy, C1/2of bilateral kidney before chemotherapy is different notably from that after2cycle chemotherapy, t=2.544、2.669, p<0.05.The other indexes have not obvious differences between eath other.The dynamic imaging qualitative evaluation results show that:the damage kidney number of lung cancer patiens after1cycle chemotherapy and after2cycle chemotherapy are12and17, and is2and4after of brest cancer patients.The rates of damage kidneys between two groups are different, u=2.90and2.62, p<0.05.Conclusion Cisplatin can affect bilateral kidney blood perfusion at early stage,and then affect filtration and discharge function of kidney with more chemotherapy. Chemotherapy drugs which are not excreted mainly through kidney have little influence on renal fuction. Renal dynamic imaging is sensitive and comprehensive on monitoring renal function, and is more valuable for patients with one side kidney impaired.