肾小球滤过率评估方法的临床适用性比较.docVIP

肾小球滤过率评估方法的临床适用性比较 　　作者：熊子波,高宙,熊祖应,陈丽,侯霜,贾少微　　作者单位：北京大学深圳医院肾内科(熊子波 熊祖应 陈丽 侯霜 罗琼)核医学科(高宙 贾少微) 　　【摘要】目的 探讨肾动态显像法，Cockcroft-Gault方程和改良简化MDRD方程在评估慢性肾脏病患者肾小球滤过率(GFR)的适用性。方法 选择慢性肾脏疾病(CKD)患者53例，以双血浆法99mTc-DTPA测的GFR为金标准，将其分为三组：A组22例GFR60 mlomin-1o(1.73m2)-1，B组12例GFR60-90 mlomin-1o(1.73m2)-1，C组19例GFR90 mlomin-1o(1.73m2)-1，将上述三种方法与双血浆法所测值进行相关分析，并在不同分组中进行比较。结果 肾动态显像法，Cockcroft-Gault方程和改良简化MDRD方程与双血浆法相关系数r分别为0.916(P0.01)，0.847(P0.01)、及0.873(P0.01)。双血浆法与肾动态显像法，Cockcroft-Gault方程和改良简化MDRD方程所测GFR[单位：mlomin-1o(1.73m2)-1]分别为，A组(23.6±13.3)，(39.3±17.3)，(25.1±17.5)及(27.7±12.1)，B组为(69.8±9.1)，(71.9±10.0)，(56.9±13.1)及(72.1±14.2)，C组为(109.4±13.6)，(108.5±20.9)，(72.7±15.2)及(89.9±13.2)，结论 三种方法均与双血浆法测的GFR有较好的相关性;肾动态显像法适用于肾功能正常及轻度肾功能不全者， Cockcroft-Gault方程适用于中重度肾功能不全者，而改良简化MDRD方程能较好的评价我国慢性肾脏疾病患者的GFR。 　　【关键词】 肾动态显像法;Cockcroft-Gault方程;改良简化MDRD方程;肾小球滤过率 　　[Abstrac]: Objective To understand the applicability of the estimation of glomerular filtrate rate (GFR ) by renal dynamic image, modified abbreviated MDRD equation and Cockcroft-Gault equation in Chinese patients with chronic kidney disease(CKD). Method 53 CKD patients were diagnosed according to K/DOQI guideline. The patients were divided into three subgroups according to the GFR obtained by two-sample method and the correlation between three methods was analysed respectively. Result There was no difference between three methods and two-sample method. The GFR [mlomin-1o(1.73m2)-1] obtained from two-sample method, renal dynamic imaging, Cockcroft-Gault equation and modified abbreviated MDRD equation was displayed as follows: group A(23.6±13.3)，(39.3±17.3)，(25.1±17.5)and (27.7±12.1)，group B(69.8±9.1)，(71.9±10.0)，(56.9±13.1)and(72.1±14.2)，group C(109.4±13.6)，(108.5±20.9)，(72.7±15.2)and(89.9±13.2). Conclusion The GFR measured by these three methods has excellent correlations with two- sample method. The method of renal dynamic imaging was used in patients with normal or mild insufficient of renal function. Cockcroft-Gault equation was u