江苏两个地区60岁以上人群肾小球滤过率的评估  

Evaluation of glomerular filtration rate in people greater than 60 years old in Jiangsu China

作　　者：孙妍蓓[1] 刘必成[2,3] 

机构地区：[1]常州市第一人民医院肾脏病科,江苏省213000 [2]东南大学附属中大医院肾脏病科 [3]东南大学肾脏病研究所

出　　处：《江苏医药》2012年第3期269-272,共4页Jiangsu Medical Journal

基　　金：科技部支撑计划(2007BAI04B10);江苏省卫生厅课题(H200936)

摘　　要：目的比较简化MDRD方程(eGFRa)、中国方程(c-aGFR3)、瑞金方程(M-MDRD-GFR)及CKD-EPI公式对60岁以上人群肾功能的评估价值。方法选取江苏两地1404名60-94岁常住居民,分为三个年龄组和三个合并症按上述方法测定肾小球滤过率(GFR),评价其与年龄的相关性,比较各方程测量肾功能的差异。结果 CKD-EPI公式计算GFR值随增龄而下降(P<0.01)。在60岁以上高血压、糖尿病及高尿酸血症人群中较低。中国方程、瑞金方程和CKD-EPI公式计算得到的高尿酸血症人群GFR值低于健康人群。中国方程、瑞金方程、CKD-EPI公式与简化MDRD方程的一致性检验Kappa值分别为0.775、0.883、0.912(P<0.01)。CKD-EPI公式与简化MDRD公式的相关性最好、偏差最小、符合率最高。结论在江苏省60岁以上人群,各种方法计算GFR值均有随增龄呈下降的趋势,CKD-EPI公式可能是比较优选的GFR评估公式。Objective To compare the values reported by four methods of original abbreviated MDRD equation（eGFRa）,the modified abbreviated MDRD equation（c-aGFR3）,the refitting MDRD equation（M-MDRD-GFR） and the Chronic Kidney Disease Epidemiology Collaboration（CKD-EPI） creatinine equation in estimation of glomerular filtration rate（GFR） in the people greater than 60 years old.Methods A total of 1404 residents aged 60 to 94 years old was randomly recruited from the community population in Jiangsu province.The values of GFR were estimated in three age groups and three complicated diseases groups.Results GFR estimated by CKD-EPI equation was decreased as age increased（P0.01）.The patients with hypertention,diabetes and hyperuricemia showed a certain decrease in GFR estimated by all equations.c-aGFR3,M-MDRD-GFR and CKD-EPI equations revealed a significant decrease of GFR in the people with hyperuricemia than in healthy people.The agreements in Kappa values on GFR estimation between c-aGFR3,M-MDRD-GFR,CKD-EPI formulas and eGFRa equation were very good,which were 0.775,0.883,0.912,respectively（P0.01）.There was a close correlation in GFR estimated by CKD-EPI equation and simplified MDRD equation with higher accuracy and less bias.Conclusion The GFR estimated by all four equations has a tendency of decrease with aging in the elder population in Jiangsu,of which CKD-EPI equation may be more suitable.

关 键 词：肾小球滤过率 慢性肾脏病 老年 

分 类 号：R692[医药卫生—泌尿科学]