肾小球滤过率评估方程对我国糖尿病合并慢性肾脏疾病患者的应用评价  

Application of modified glomerular filtration rate(GFR) estimation equations in Chinese diabetic patients with chronic kidney disease in diabetes

作　　者：常虹[1] 谈敏[1] 叶山东[2] 

机构地区：[1]安徽医科大学附属安徽省立医院干三病区,合肥230001 [2]安徽医科大学附属安徽省立医院内分泌科,合肥230001

出　　处：《中国糖尿病杂志》2013年第5期422-425,共4页Chinese Journal of Diabetes

基　　金：2009年安徽省卫生厅青年科研基金资助(09B131)

摘　　要：目的评价肾小球滤过率(GFR)评估方程对我国糖尿病慢性肾脏疾病(CKD)患者的适用性。方法选择294例糖尿病患者,用瑞金方程、CG方程、MDRD方程分别预测GFR值,与99mTc-DTPA测得的GFR(sGFR)进行比较。结果 Bland-Altman分析显示瑞金方程估计的eGFR和sGFR的一致性最好,一致性限度为-37.2～50.2,但所有方程估计的eGFR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,瑞金方程估测的eGFR与X轴的斜率为0.15,与Y轴的截距为-6.52,均比其他方程更小。瑞金方程估测eGFR 15%、30%和50%符合率均较高,且估测eGFR 30%符合率高于70%。3种估算公式受血糖的影响均较小。结论瑞金方程可能更适合我国CKD患者评估GFR。Objective To evaluate the applicability of modified formulas based on plasma creatinine levels in Chinese diabetic patients with chronic kidney diseases （CKD）. Methods A total of 294 diabetic patients were investigated. Glomerular filtration rate （GFR） was estimated with the Ruijin equation, Cockeroft-Gauh （CG）, and Modification of Diet in Renal Disease （MDRD） formula. The accuracy of estimated GFR was compared with 99mTc-DTPA-GFR （sGFR）. Results Bland-Altman analysis demonstrated that the Ruijin equation was more consistent with sGFR than the other equations. However, all the equation estimated GFR and sGFR consistency limits exceeded the pre-ordained values. Linear regression analysis showed that in the GFR of Ruijin equation, the slope of X axis was 0.15, and the intercept of Y axis 6.52, both were smaller than in other equations. The 15%, 30%, and 50% accuracies of the Ruijin equation was higher than those of other equations, and the 30% accuracy of Ruijin equation was more than 70%. There was no significant difference between poorly-controlled group and well-controlled group in three equations, which were hardly influenced by blood glucose. Conclusions Ruijin equation is more applicable in Chinese diabetic patients with CKD.

关 键 词：糖尿病 肾小球滤过率 慢性肾脏病 

分 类 号：R692[医药卫生—泌尿科学]