| Objectives:To explore the significance of 99mTechnetium-diethyene triaminepentaacetic acid(99mTc-DTPA)renal dynamic imaging of glomerular filtration rate(GFR), apex time(Tb), half excretion time(C1/2) and urine β2-microglobulin(β2-MG) determination in the evaluation of early renal function damage of patients with Gynecological tumor after cis-diaminodichloroplatinum(DDP) chemotherapy. To investigate the correlation between GFR and blood SCr, BUN, urineβ2-MG. To seek a feasible determination method to evaluate the damage of kidney, and to provide reference for the adjustment of remedy project.Methods: 80 patients underwent 99mTc-DTPA renal dynamic imaging were enrolled, they had no previous history of diabetes mellitus, or renal disease. 50 patients with gynecological tumor after DDP chemotherapy were set as study group, and 30 cases of patients with breast cancer without DDP chemotherapy were set as control group. 99mTc-DTPA renal dynamic imaging was performed to estimate GFR,Tb and C1/2 before, 1 and 2 periods after chemotherapy in both groups. At the same time, the blood BUN,SCr and urine β2-MG were assayed. All patients in both groups had no contraindication to chemotherapy and no renal toxicity medicine was used during chemotherapy. The data of GFR,Tb,C1/2 by 99mTc-DTPA renal dynamic imaging and blood BUN,SCr and urine β2-MG were compared and analyzed. Independent samples t test was performed between groups, paired samples t test was conducted before, 1 and 2 periods afterchemotherapy in both groups, Pearson correlation analysis was used to perform correlation analysis. Area under curve of GFR,BUN,SCr and blood,urine β2-MG was compared by receiver-operator characteristic(ROC). P<0.05 was treated as statistical difference and P<0.01 was significant.Results: To patients with gynecological tumor after DDP chemotherapy, the dat a by 99mTc-DTPA renal dynamic imaging were as follows: GFR in double kidn eys before, 1 and 2 periods after chemotherapy were 97.17±15.34ml/min, 93.50±7.89 ml/min and 74.67±4.27 ml/min, respectively. The difference between be fore and 1 period after chemotherapy was not significant(t=0.506,p=0.635). The difference between before and 2 periods after chemotherapy was significant(t=3.395,p=0.019). The left and right renal GFR before, 1 and 2 periods after chem otherapy were 3.00±0.11 min,2.89±0.10 min,3.57±0.38 min,3.52±0.41 min and 4.71±0.79 min,4.83±0.91 min, respectively. The difference between before and 1 p eriod after chemotherapy was significant(t=5.312,5.269,all P<0.05). The differen ce between before and 2 periods after chemotherapy was significant(t=4.556,5.180, all P <0.05). The left and right renal C1/2 before, 1 and 2 periods after che motherapy were8.00±0.22 min,7.91±0.21 min,8.34±0.11 min,8.41±0.10 min,and9.12±0.43 min,9.34±0.51 min,respectively. The difference between before and 1 per iod after chemotherapy was significant(t=5.00,4.99,all P<0.05). The difference b etween before and 2 periods after chemotherapy was significant(t=5.085,5.033,all P <0.05). Urine β2-MG before, 1 and 2 periods after chemotherapy were 0.15±0.05 mg/L, 0.29±0.05mg/L and 0.30±0.04 mg/L, respectively. The difference between before and 1 period(2 periods) after chemotherapy was significant(t=5.395,6.060,all P<0.05).(2)The data of dual renal GFR, single renal Tb and C1/2from 99mTc-DTPA renal dynamic imaging and urine β2-MG in breast cancer patients without DDP therapy wasnot significant(all P>0.05)between before and 1 period(2 periods) after chemotherapy.(3)The data of blood BUN,SCr and β2-MG between study group and control group was not not significant(all P>0.05)(4)BUN,SCr and β2-MG(blood and urine) was correlated with GFR(study group:r=-0.43,-0.31,-0.35,-0.81;control group:r=-0.40,-0.29,-0.30,-0.78), and urine β2-MG was significantly correlated with GFR.(5)Area under curve of GFR,urine β2-MG was large in both study group and control group.Conclusion: The application of 99mTc-DTPA renal dynamic imaging and determin ation of β2-microglobulin level in urine in the evaluation of early renal function damage of patients with gynecological tumor after cis-diaminodichloroplatinum(D DP)chemotherapy is of importance. It can find the kidney damage from cis-diami nodichloroplatinum(DDP)chemotherapy earlier. Which has certain clinical significa nce in rational medicine usage, observing and protecting kidney. |
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