肾小球滤过率评估公式在慢性肾脏病患者中的应用比较  

Comparison of GFR estimating measurements in patients with chronic kidney disease

作　　者：孟瑚[1] 喻箴[2] 罗惠民[1] 

机构地区：[1]昆明云南省第一人民医院肾内科,650032 [2]昆明医科大学公共卫生学院流行病与卫生统计系

出　　处：《国际移植与血液净化杂志》2015年第2期22-25,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的比较四种肾小球滤过率评估公式在慢性肾脏病患者中的应用价值。方法对952例患者，以99mTc．DTPA动态显像法测定的肾小球滤过率（mGFR）为标准，测定血清肌酐和胱抑素C，用Coekcroft．Gauh、简化MDRD、Levey1、CKD-EPI公式计算出eGFR，与mGFR进行比较。结果CG、简化MDRD、Levey1、CKD-EPI与mGFR的相关系数分别为0．924、0．922、0．900、0．917；差值的均值分别为1．7、3．6、4．6,8．2。CG估计值在CKD1期和2期时与mGFR差异无统计学意义（P=0．144），CKD-EPI估计值在CKD1期时与mGFR差异无统计学意义（P=0．102）。而从CKD3期到CKD4期，四种方法估计值与mGFR差异均有统计学意义（P=0．144）。结论CG公式在中国CKD患者中的适用性高于简化MDRD公式、CKD．EPI公式和Leveyl公式。Objective To assess the diagnostic value of 4 equations using different variables for determining glomerular filtration rate in patients with CKD. Methods Retrospective observational study was performed on 952 patients. Uptake of 99mTc-DTPA application for determination of glomerular filtration rate （mGFR）. Serum ereatinine and cystatin C level were measured in all patients. Used the Cockcroft-Gault, abbreviation MDRD, Levey 1 and CKD-EPI equations to estimate the GFR （eGFR）. The correlation between eGFR and mGFR were analysed respectively. Results The correlation coemcient of CG, abbreviation MDRD, Levey 1 and CKD-EPI were 0.924, 0.922, 0.900 and 0.917, respectively. The mean differences were 1.7, 3.6, 4.6 and 8.2, respectively. Compared with mGFR the eGFR derived from CG showed no significant difference in patients with CKD stages land 2 （ P = 0. 144） ; the eGFR derived from CKD-EPI showed no significant difference in patients with CKD stages 1 （ P = 0. 102）. But significant difference was found between eGFR which derived from 4 equations and mGFR in patients with CKD stages 3 and 4. Conclusion CG equation is more accurate than others in Chinese CKD patients.

关 键 词：肾小球滤过率 慢性肾脏病 99mTc-DTPA肾动态显像法 肾小球滤过率评估公式 

分 类 号：R692[医药卫生—泌尿科学]