不同年龄健康人肾脏滤过功能评价指标的生理范围及影响因素  

The Physiological Range of Renal Filtration Function Index and its Influencing Factors in Healthy People of Different Ages

作　　者：曹聃 张伟光[1] 张银平 聂飒飒 宋康康 贾林沛 刘晓敏[1] 孙雪峰[1] 陈香美[1] 

机构地区：[1]解放军总医院肾病科肾脏疾病国家重点实验室暨慢性肾病国家临床医学研究中心,北京100853

出　　处：《中国中西医结合肾病杂志》2017年第5期409-412,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家"973"项目(No.2013CB530800)

摘　　要：目的:建立不同年龄健康人的肾脏滤过功能指标的生理范围,并分析其增龄和性别的影响。方法:通过询问一般情况、病史及体格检查,并检测血常规、尿常规、生化等指标,入选1 803例健康人群。自动生化分析仪检测血清尿素氮(BUN)及肌酐(Scr,胱氨酸酶法测定),免疫比浊法检测血清胱抑素C(Cys C),3种CKD-EPI公式计算e GFR。结果:(1)获得不同年龄组别、不同性别的BUN、Scr、Cys C及3种公式计算e GFR的95%参考值范围。(2)无论性别,Scr、BUN、Cys C均随增龄升高,GFRCr、GFRCys C、GFRCr-Cys C随增龄逐渐降低;但男>80岁组的Scr值较60岁~80岁组明显降低。(3)各年龄组中女Scr和BUN、女<60岁的Cys C低于男,60岁以上年龄组Cys C无性别差异。(4)除年龄>80岁以及20岁~40岁女组外,同年龄组同性别人群的3种CKD-EPI公式计算的GFR差异均存在统计学意义。结论:本研究提供了不同年龄、性别的临床常用肾脏滤过功能评估参数的生理范围,并证实了年龄和性别对这些参数的影响,为临床正确评估肾功能提供参考。Objective：To establish the physiological range of renal filtration function index in healthy people, and to analyze the influence of age and gender. Methods：The general physiological condition, medical history and physical examination, and blood routine examination, urine routine and biochemical indicators of 1803 healthy people were tested. The automatic biochemical analyzer to detect the serum urea nitrogen （BUN） , creatinine （Scr determined by cystine enzyme method）, and serum cystatin C （CysC determined by immune turbidimetry）. 3 CKD - EPI formulas to caculate eGFR. Results： （ 1 ） The 95% reference values of BUN, Scr, CysC and the eGFR of the 3 formulas were obtained for different ages and genders. （2）Regardless of gender, Scr, BUN, CysC increased with age, while GFRcr, GFRcy^c, GFRcr_ Cy^C gradually decreased with age. However, the Scr level of male over 80 years old was significantly lower than that of 60 years old ~ 80 years old. （3）The Scr and BUN in women of all age and CysC levels in women younger than 60 years were lower than those of males, and CysC levels have no difference in both gender over 60 years old. （ 4 ） Except for 20 years old - 40 years old female group and over 80 years old group in both gender, there were significant differences in the GFRs of the 3 CKD - EPI formulas of the same gender and age. Conclusion：In this study, we introduced the physiological range of renal filtration function index in different ages and genders, and confirmed the effects of age or gender on these parameters , and provide reference for clinical evaluation of renal function.

关 键 词：健康人 血肌酐 血清尿素氮 血清胱抑素C eGFR 

分 类 号：R692[医药卫生—泌尿科学]