于天舒^1,,
李美云^1,,,
常瑞亭²,
孙瑞雪²,
姜立杰²
1. 河北省衡水市人民医院 1.?核医学科；2.?影像中心，河北 衡水 053000
2. 影像中心，河北 衡水 053000

基金项目: 衡水市科技计划自筹经费项目（2018014021Z）


详细信息 作者简介: 于天舒（1990-），女，主治医师。E-mail：yts_ning@163.com





通讯作者: 李美云，主任技师。E-mail：lmylmy0711@163.com 中图分类号: R445.3


摘要:目的 研究不同肾周脂肪评分（Mayo adhesive probability，MAP）系统分组的T1期肾肿瘤行腔镜下部分切除术前及术后双侧肾脏肾小球滤过率 （glomerular filtration rate，GFR）变化的差异性，从而评估不同MAP评分对T1期肾肿瘤部分切除术后GFR恢复程度的指导意义。方法 回顾性分析2016年1月至2021年6月期间收治的115例行腹腔镜肾部分切除术的T1期肾肿瘤患者的临床病例资料。按MAP评分标准分为MAP低分组（0～1分）36例、MAP中分组（2～3分）49例和MAP高分组（4～5分）30例。比较不同MAP组间患者术前、术后双侧肾脏GFR值及术后GFR值变化程度的差异性。结果 MAP高分组患者术前患侧肾脏GFR值稍低于其他组，健侧GFR值高于其他组，差异有统计学意义（P＜0.05）；所有患者术后患侧肾脏GFR值较术前均有所减低，健侧肾脏术后GFR可见代偿性增加，差异有统计学意义（P＜0.05）；患者患侧肾脏GFR值减低程度及健侧肾脏代偿性增加程度随MAP评分的增加呈逐渐增高趋势，差异有统计学意义（P＜0.05）。结论 MAP高分患者术前患侧肾脏GFR值已有明显减低，且MAP评分越高，术后GFR恢复情况越差。
关键词: GFR/
肾动态显像/
MAP评分/
T1期肾肿瘤/
肾部分切除术


Abstract:ObjectiveTo study the difference of GFR value after endoscopic partial nephrectomy for T1 renal tumor in different MAP groups, so as to evaluate the guiding significance of different MAP scores in the recovery of GFR after partial resection of T1 renal tumor.MethodsThe clinical data of 115 patients with T1 renal tumor, who underwent laparoscopic partial nephrectomy in our hospital from January 2016 to June 2021, were retrospectively analyzed. According to the MAP scoring criteria, there were 36 cases in the MAP low group (0-1 points), 49 cases in the MAP middle group (2-3 points), and 30 cases in the MAP high group (4-5 points). The differences of preoperative and postoperative GFR values and the changes of postoperative GFR values among different MAP groups were studied.ResultsThe preoperative GFR of the diseased kidney in the high MAP group was slightly lower than that in the other groups, and the GFR of the healthy kidney was higher than that in the other groups (P＜0.05). The GFR of the diseased kidney was decreased in all patients after operation, while the GFR of the healthy kidney was increased (P＜0.05). The degree of GFR decrease of the diseased kidney and the degree of GFR increase of the healthy kidney showed a positive correlation with MAP score (P＜0.05).ConclusionThe GFR value of the diseased kidney before surgery has been significantly reduced in patients with high MAP, and the higher the MAP score, the worse the recovery of GFR value after surgery.
Keywords:GFR/
renal dynamic imaging/
imaging-based MAP score/
T1 renal tumor/
partial nephrectomy

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