肾小球滤过率评估方程在慢性肾小球肾炎患者中的应用评价  

Application of glomerular filtration rate estimation equations in chronic glomerulonephritis.

作　　者：刘迅[1] 王成[1] 唐骅[1] 陈珠江[1] 叶增纯[1] 娄探奇[1] 

机构地区：[1]中山大学附属第三医院肾内科,广州510630

出　　处：《中国综合临床》2009年第6期607-609,共3页Clinical Medicine of China

摘　　要：目的评价Cockcroft—Gault（CG）方程及肾脏疾病膳食改良试验（MDRD）方程计算的肾小球滤过率（GFR）在慢性肾小球肾炎患者的适用性。方法选择2005年1月至2007年12月在中山大学附属第三医院肾内科就诊的慢性肾小球肾炎患者143例，用CG方程、MDRD1方程和简化MDRD方程，分别计算GFR值与^99Tc^m-DTPA检测的GFR（sGFR）进行比较。结果Bland-Altman分析显示CG方程估计的GFR和sGFR的一致性较好，但所有各方程估计的GFR和sGFR的一致性限度均超过事先规定的专业界值。线性回归结果显示，CG方程估测的GFR与X轴的斜率较其他方程更接近0。从总体以及慢性肾脏病（CKD）的不同分期分析，CG方程较其他方程有较小的偏差和更优的准确性。结论对于慢性肾小球肾炎患者肾功能的评估，当血肌酐的测定方法为酶法时，CG方程优于MDRD1方程和简化MDRD方程。Objective To evaluate the applicability of glomerular filtration rate （GFR） calcuated by Cockcroft-Gauh equation, MDRD1 equation and abbreviated MDRD equation in the chronic glomerulonephritis. Methods 143 chronic kidney disease（CKD） patients diagnosed in our hospital from January 2005 to December 2007 were investigated. Glomerular filtration rate （GFR） was estimated with Cockcroft-Gault equation, MDRD1 equation and abbreviated MDRD equation. The accuracy of estimated GFRs was compared with ^99Tc^m-DTPA-GFR in chronic glomerulonephritis patients. Results Bland-Ahman analysis demonstrated that Cockcroft-Gault equation was more consistent with GFR and sGFR than the other equations. Linear regression analysis showed that the slopes of Cockcroft-Gault equation were closer to the identical line,with a smaller bias and higher accuracy. When compared, the bias as well as accuracy of estimated GFRs with sGFR in different stages of CKD, Cockcroft-Gauh equation showed good results. Conclusion When plasma creatinine is checked with enzymatic method, Cockcroft-Gault equation is more appropriate than MDRD1 equation and abbreviated MDRD equation for estimating renal function in chronic glomerulonephritis patients.

关 键 词：慢性肾小球肾炎 评估方程 肾小球滤过率 

分 类 号：R692.31[医药卫生—泌尿科学]