基于不同体重计算的Cockcroft-Gault公式估算值与99mTc-DTPA肾小球滤过率一致性比较  

The Consistency of the Cockcroft-Gault Formula Based on Different Body Weight with the 99mTc-DTPA Glomerular Filtration Rate

作　　者：陈金玲 CHEN Jinling(Sanming First Hospital Affiliated to Fujian Medical University,Sanming 365000,China)

机构地区：[1]福建医科大学附属三明第一医院,福建三明365000

出　　处：《中外医学研究》2020年第29期4-7,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析不同体重指数慢性肾脏病(CKD)患者采用实际或理想体重代入Cockcroft-Gault(CG)公式的肾小球滤过率估算值(eGFR)与基于99mTc-DTPA肾动态显像法测定的肾小球滤过率(rGFR)一致性。方法:选取182例CKD患者为研究对象,以99mTc-DTPA肾动态显像法测定的肾小球滤过率为参考,根据体重指数将研究对象分为正常体重组(A组,18.5 kg/m^2≤BMI<25 kg/m^2)和超重组(B组,BMI≥25 kg/m^2),分别使用实际体重和理想体重代入CG方程,计算两组患者eGFR,用偏倚、标准差、P30和95%一致性比例评价eGFR和rGFR一致性。结果:A组107例,B组75例。A组以实际体重或理想体重代入CG公式计算出的eGFR,其值均低于rGFR,平均偏差9.9和10.4 ml/[min·(1.73 m^2)];以rGFR为参考,两种体重计算出的eGFR,偏倚、精确度、P30和95%一致性比例差异无统计学意义(P>0.05)。B组患者以实际体重代入CG公式计算出的eGFR高于rGFR,平均高8.7 ml/[min·(1.73 m^2)],理想体重代入CG公式计算出的eGFR低于rGFR,平均低5.42 ml/[min·(1.73 m^2)];理想体重计算的eGFR偏倚、精确度优于以实际体重计算的eGFR(P<0.05)。结论:用CG公式评价CKD患者肾小球滤过率时,在正常体重人群,可以使用实际体重,在超重人群,应当使用理想体重计算。Objective:The consistency of the estimated glomerular filtration rate(eGFR)of patients with chronic kidney disease(CKD)with different body mass index(BMI)using the Cockcroft-Gault(CG)formula with the estimated glomerular filtration rate(rGFR)based on 99mTc-DTPA renal dynamic imaging.Method:A total of 182 patients with CKD were selected as the study objects,the glomerular filtration rate measured by 99mTc-DTPA renal dynamic imaging was used as a reference,subjects were divided into normal weight group(group A,18.5 kg/m^2≤BMI<25 kg/m^2)and overweight group(group B,BMI≥25 kg/m^2)according to BMI,using actual weight and ideal weight respectively,eGFR was calculated in both groups,the consistency of eGFR and rGFR was evaluated with bias,standard deviation,P30,and 95%consistency limits.Result:There were 107 patients in the group A and 75 patients in the group B.Bland-Altman plot showed that eGFR calculated by both actual and ideal body weight in CG formula in the group A was lower than rGFR,with an average deviation of 9.9 and 10.4 ml/[min·(1.73 m^2)].With rGFR as the reference,there were no differences in the bias,accuracy,P30 and 95%consistent limit ratio of eGFR calculated by the two body weights(P>0.05).In the group B,the eGFR calculated by actual body weight substituting CG formula was higher than that of rGFR,with an average height of 8.7 ml/[min·(1.73 m^2)],the eGFR calculated by ideal body weight substituting CG formula was lower than that of rGFR,with an average decrease of 5.42 ml/[min·(1.73 m^2)].EGFR bias and accuracy of ideal body weight were better than eGFR calculated based on actual body weight(P<0.05).Conclusion:When evaluating glomerular filtration rate in CKD patients with CG formula,actual body weight can be used in people of normal weight,and ideal body weight should be used in people with overweight.

关 键 词：慢性肾脏病 99mTc-DTPA肾动态显像法 COCKCROFT-GAULT公式 实际体重 理想体重 

分 类 号：R692[医药卫生—泌尿科学]