99mTc-DTPA肾动态显像与Cockcroft-Gault公式对肾功能评价的比较  

The renal function as assessed by 99mTc-DTPA renal dynamic imaging and Cockcroft-Gault formula：a

作　　者：刘秀芹[1] 郭悦[1] 于治国[1] 秦嵩[1] 姚稚明[1] 

机构地区：[1]北京医院核医学科,100730

出　　处：《中国临床实用医学》2016年第3期38-40,共3页China Clinical Practical Medicine

摘　　要：目的：比较99mTc-DTPA 肾动态显像Gates法测定的GFR（gGFR）和Cockcroft-Gault（C-G）公式估算的GFR（eGFR）之间的差异，并评价两者在对慢性肾脏病患者分期的一致性。方法选择2009年3月至2011年9月于北京医院核医学科行肾动态显像的肾病患者945例，计算gGFR与eGFR。使用配对比较的秩和检验（Wilcoxon检验）比较两者差异；Spearman相关分析比较两者相关性；分别根据gGFR与eGFR将患者分期，用κ检验进行一致性比较。结果（1）945例患者eGFR中位数为51.8，高于gGFR的44.6，且差异有统计学意义（Z=-12.53， P〈0.001）；（2）相关性分析结果显示两者的相关性较好（r=0.719，P〈0.001）；（3）分别根据gGFR与eGFR对患者进行分期，两者的总体符合率为63.3%（598/945），κ一致性检验示两者具有中度一致性（κ=0.405，P〈0.001）；（4）根据gGFR分期，除1期与2期间肌酐水平无明显差异外（Z=-1.844，P=0.065），其余各组间肌酐水平均有显著性差异（均P〈0.001），且随着分期增加，肌酐值也逐渐增高。结论99mTc-DTPA肾动态显像法与C-G公式法所测得的GFR值具有良好的相关性，且在慢性肾脏病患者分期中具有一致性。在临床上两种方法互为补充，可以综合运用以准确判断患者的肾功能水平。Objective To evaluate the difference of the glomerular filtration rate （GFR） estimated by 99mTc-DTPA renal dynamic imaging （gGFR） and Cockcroft-Gault（C-G）formula（eGFR）, and the consistency in the staging of the chronic kidney disease patients. Methods gGFR and eGFR were calculated from the data of 945 chronic kidney disease patients who underwent the dynamic renal imaging. Wilcoxon test was performed to determine the difference of the two and the Spearman test for the correlation. Kappa test was used to evaluate the consistency of the staging of the patients, according to the gGFR and eGFR respectively. Results （1） The global eGFR （median 51.8）was significantly higher than gGFR（median 44.6）, Z=-12.53, P〈0.001;（2） there was a strong correlation between gGFR and eGFR （r=0.719, P〈0.001）;（3） the patients were divided into 3 stages （compensatory stage, moderately decreased stage and severely decreased stage ） according to eGFR and gGFR respectively, the global coincidence rate was 63.3%（598/945） with moderate consistency （Kappa=0.405, P〈0.001）;（4） when the patients were divided into 5 stages according to the gGFR, the serum creatinine value showed significant difference between every two stages （P〈0.001） except stage1 and 2 （Z=-1.844,P=0.065）, and the creatinine value increased as the stage going up. Conclusion There was a strong correlation between the GFR value estimated by 99mTc-DTPA renal dynamic imaging and C-G formula, and a moderate consistency in the staging of the chronic renal disease patients. The two methods are complementary with each other and should be comprehensively utilized to accurately assess the renal function.

关 键 词：肾小球滤过率 肾功能 DTPA 

分 类 号：R692[医药卫生—泌尿科学]