CKD-EPI方程对IgA肾病患者肾小球滤过率评估的适用性研究  

Research on the evaluation's applicability of CKD-EPI equation on gluomerular filtration in paitents with IgA nephropathy

作　　者：刘红春[1] 李晋[1] 任春锋[1] 苏利沙[2] 谭雷[3] 李敏霞 

机构地区：[1]郑州大学第一附属医院检验科,河南郑州450052 [2]郑州大学第一附属医院产前诊断实验室,河南郑州450052 [3]郑州大学第一附属医院肾内科,河南郑州450052 [4]河南省第二人民医院检验科,河南郑州450000

出　　处：《中国卫生检验杂志》2016年第7期969-971,共3页Chinese Journal of Health Laboratory Technology

基　　金：河南省卫生厅科技攻关项目资助课题(2011020036)

摘　　要：目的探讨基于血肌酐(SCr)和胱抑素C(Cys-C)的3个慢性肾脏病流行病学合作研究组(CKD-EPI)肾小球滤过率(GFR)评估方程对我国Ig A肾病患者的适用性。方法选取经肾穿刺活检组织检查确诊为Ig A肾病的116例住院患者,以99m Tc-二乙三胺五醋酸肾动态显像检测GFR作为标准GFR(s GFR),应用CKD-EPI SCr方程(GFR1)、Cys-C方程(GFR2)和SCr-Cys-C联合方程(GFR3)计算GFR与s GFR进行相关性分析,并用受试者工作特征(ROC)曲线评价各方程在CKD分期中的诊断价值。结果 3种CKD-EPI方程计算GFR结果同s GFR均有显著相关性(r值分别为0.745、0.723、0.740,P<0.05);以s GFR为参照对Ig A肾病患者进行CKD分期,GFR1、GFR2和GFR3方程的ROC曲线下面积分别为0.840、0.825、0.845。结论 3个CKD-EPI方程对评估Ig A肾病患者GFR及CKD分期均有一定诊断价值,其中CKD-EPI SCr-Cys-C联合方程计算的GFR同s GFR最接近,对患者CKD分期更准确,因此评估Ig A肾病患者GFR推荐使用SCr-Cys-C联合方程。Objective To evaluate the application of CKD- EPI equations on gluomerular filtration rate（ GFR） in paitents with3 chronic kidney failures based on SCr and Cys- C in our country. Methods 116 hospitalized patients with Ig A nephropathy validated by kidney biosy were selected. 99 m Tc- DTPA renal dynamic imaging was performed to detected the subjects＇ GFR,which was set as the standard GFR（ s GFR）. In addition to analyze their correlation respectively,the GFR calculated by CKD-EPI SCr formula（ GFR1）,Cys- C formula（ GFR2） and SCr- Cys- C combiened formula（ GFR3） was compared to s GFR.ROC curve was drew to evaluate the clinical diagnostic significance in the staging of CKD. Results The calculation results of the 3 CKD- EPI equations were all correlated with s GFR significantly（ r = 0. 745,0. 723,0. 740,P〈0. 05）. The areas under ROC of GRF1,GRF2 and GRF3 was 0. 840,0. 825,0. 845 respectively in the staging of CKD when the s GFR was set as the reference. Conclusion All of the three CKD- EPI formulas are of certain diagnostic value in evaluating GFR of patients with Ig A nephropathy. The GFR based on CKD- EPI SCr- Cys- C combined formula（ GFR3） is similar to s GFR,and has higher accuracy in CKD staging,in conclusion,it＇s recommended to use CKD- EPI SCr- Cys- C combined formula in evaluating the GFR of patients with Ig A nephropathy.

关 键 词：IGA肾病 肾小球滤过率 胱抑素C CKD-EPI方程 

分 类 号：R692[医药卫生—泌尿科学]