一种慢性肾衰竭临床分期的新指标尿血肌酐比值.doc

一种慢性肾衰竭临床分期的新指标：尿、血肌酐比值 杨建军 崔世维 朱晓晖 朱静仪 钱桐荪 【摘要】目的 探讨在尿浓缩状态下尿肌酐浓度(urine creatinine, Ucr)与血清肌酐浓度(serum creatinine, Scr)的比值（Ucr/Scr）能否作为肾小球滤过率(glomerular filtration rate, GRF)检测的指标，进而作为慢性肾功能衰竭（chronic renal failure，CRF）y=0.7493552x+8.675045, r =0.9027, P0.01。② Ucr/Scr分期标准的总敏感性（0.8529）和总特异性（0.8382）都较高。结论Ucr/Scr可作为肾小球滤过率检测的指标，并可以作为CRF分期的指标。Ucr/Scr的临床分期标准为：正常人Ucr/Scr：90～；肾功能代偿期(肾贮备能力下降期)Ucr/Scr：50～；肾功能不全期(氮质血症期)Ucr/Scr：20～；肾衰竭期Ucr/Scr：9～；尿毒症期Ucr/Scr：9。 【关键词】尿肌酐浓度：血清肌酐浓度；慢性肾功能衰竭；内生肌酐清除率 A New Index of Chronic Renal Failure Stages: Ratio between Urine and Serum Creatinine Yang Jian-jun, Cui Shi-wei, Zhu Xiao-hui, et al. Department of nephron, Affiliated Hospital of Nantong University, Nantong 225001, China 【Abstract】 Objective To investigate whether the ratio(Ucr/Scr) between urine creatinine(Ucr) and serum creatinine(Scr) can be regarded as the examination marker of glomerular filtration rate(GFR), then as the examination marker of the stages of chronic renal failure(CRF), when urine was concentrated. Methods ① Firstly endogenous creatinine clearance rate (Ccr) was mensurated. Secondly Ucr/Scr was mensurated when urine was concentrated. Finally Ucr/Scr was compared with Ccr.② Ucr/Scr was mensurated in patients with different stages of CRF and the standard of Ucr/Scr was acquired according to 95％ confidence interval of Ucr/Scr. ③ The standard of Ucr/Scr was used to clinic patients with different stages of CRF to look for its sensitivity and speciality. Results ① The relativity between Ucr/Scr and Ccr was significant in urine concentration stage. The linear equation was as following: y=0.7493552x+8.675045, r =0.9027, P0.01. ② The sensitivity （0.8529）and speciality（0.8382） of the standard of Ucr/Scr were both high. Conclusions Ucr/Scr can be regarded as the examination marker of GFR, then as the examination marker of the stages of CRF. The standard of Ucr/Scr is as following: natural persons(90~), substituted stage (50~), not substituted stage (20~), prostrate stage (