基于胱抑素C的肾小球滤过率评估方程的建立与验证  

Establishment and validation of an estimating formula for glomerular filtration rate based on Cystatin C

作　　者：李辉军[1] 熊志刚[1] 汪俊[1] 程黎明[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院检验科,湖北武汉430030

出　　处：《国际检验医学杂志》2013年第5期562-564,567,共4页International Journal of Laboratory Medicine

摘　　要：目的以疑似肾脏病患者为研究对象建立基于血浆胱抑素C(CystatinC)的肾小球滤过率(GFR)评估方程,并对其进行适用性评价。方法收集2011年10月至2012年4月在该院核医学科进行GFR检查的肾功能受损患者样本200例,男113例,女87例,记录患者性别、年龄、身高、体质量及临床资料等,并分为模型组和模型验证组。应用99Tcm-DTPA清除法测定GFR(mGFR),酶法测定血浆肌酐(pCr)浓度,胶体金颗粒免疫分析法(SPIA)测定血浆CystatinC(pCys-C)浓度,比较pCr和pCys-C分别与mGFR的相关性,并在模型组利用多重线性回归模型以与mGFR相关性较好的pCys-C建立适于肾功能受损患者的GFR的评估方程(eGFR),采用模型验证组来验证建立的GFR评估方程的准确性并与同类的Hoek模型和Orebro模型来进行适用性比较。结果根据模型组pCys-C和mGFR的数据进行统计学处理,得到GFR预估方程为eGFR=60.873/pCys-C+10.863。经检验,模型所得eGFR与模型验证组mGFR分布无差异,本研究预测模型的30%和50%准确性高于Hoek模型和Orebro模型,准确度较好。结论本模型与同类研究所得到的基于CystatinC的eGFR预测模型相比,有较好的预测能力,可尝试用于临床肾功能受损患者GFR水平的预测。Objective To develop an estimating formula for glomerular filtration rate（GFR）based on Cystatin C in patients with nephropathy.Methods 200cases of patients with nephropathy who had examinations of kidney function tests in Tongji hospital Nuclear Medicine department from October 2011to April 2012have been enrolled.The patients were randomly divided into model group and model validation group and their gender,age,height,weight and related clinical data were recorded.The mGFR obtained from99mTc-DTPA clearance rate was used as a reference rate value of GFR.Plasma creatinine（pCr）was detected in enzyme method and the plasma Cystatin C（pCys-C）in Sol particle immunoassay.Compared the correlation of pCr C and pCys-C with mGFR respectively.used multiple linear regression model to establish the prediction model which is suitable for estimating the eGFR of suspected patients with nephropathy based on pCys-C,which is more related to mGFR in model group.Meanwhile made Comparison and evaluation of applicability between Model validation group and its congeneric models（Hoek model and Orebro model）.Results With standardised countdown conversion,pCys-C showed linear correlation with mGFR.The formula was eGFR=60.873/Cys-C＋10.863.No significant difference was found between the distribution of eGFR and mGFR.Our formula had an accuracy of 30%and 50%,which were no less than those obtained from Hoek and Orebro formula.The new formula also had acceptable bias and high precision.Conclusion The GFR predication formula we established has a good prediction performance as comparised with other foumula,which could attempt to be used in measuring GFG in patients with nephropathy.

关 键 词：胱抑素C 肾小球滤过率 肌酸酐 评估方程 

分 类 号：R692[医药卫生—泌尿科学]