MDRD方程在我国慢性肾脏病患者中的改良和评估

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1、万方数据史堡堑壁痘茎查!塑!生!!旦箜丝鲞箜!Q塑鱼堕也』堕!P!型：Q!!!垒!!兰Q堕：∑!!丝：塑!：!QMDRD方程在我国慢性肾脏病患者中的改良和评估全国eGFR课题协作组【摘要】目的开发适合我国慢性肾脏病(CKD)患者的肾小球滤过率(GFR)评估方程。方法收集国内不同地域、肾功能不同分期的CKD患者684例的有关资料。随机选取454例为开发组，230例为验证组。以双血浆法咖rc．DTPA血浆清除率为GFR参考值。(1)在简化MDRD方程中添加种族系数；(2)多元逐步回归线法开发新的GFR评估方程；(3)将上述两种改良的方程

2、与改良前简化MDRD方程进行偏离度、精确度、准确性比较。结果684例患者中，男352例，女332例，平均年龄(49．9±15．8)岁。上述两种改良的简化MDRD方程在肾功能不同分期内偏离度分别为543．0、677．2和2175．0任意单位；精确度分别为57．5、56．5和60．7ml·rain一·(1．73m2)～；准确性均优于改良前简化MDRD方程，差异有统计学意义(30％的准确性由66．1％提高至77．8％和79．6％，P<0．05)。结论基于我国CKD人群特点，改良的简化MDRD方程与改良前方程相比，表现了显著的优势，可以替代

3、改良前简化MDRD方程，应用于我国CKD患者的GFR评估。【关键词】肾疾病；肾小球滤过率；评估方程；血浆清除率ModificationandevaluationofMDRDestimatingequationforChinesepatients谢thchronickidneydiseaseChineseeGFRInvestigationCollaborationCorrespondingauthor：MAYing—chun，ZUOLi，DepartmentofNephrology，TheFirstHospital，PekingUnb

4、”ersity，100034Bering，Email：zuoli@bjmu．edu．cn【Abstract】ObjectivesTomodifyglomerularfiltrationrate(GFR)estimatingequation(alsocaHedabbreviatedMDRDequation)basedonplasmacreatinine(Pcr)andotherdemographicdatafromChinesechronickidneydisease(CKD)population，andcomparethediagn

5、osticperformanceofthemodifiedabbreviatedMDRDequationswiththatoforiginalabbreviatedMDRDequationindifferentCKDstages．MethodsSixhundredandeighty-fourpatientswithCKDincluding352malesand332females，withaverage(49．9±15．8)years，werecollectedfrom9renalinstitutesofuniversityhosp

6、itallocatedin9differentgeographicregionsofChina，andwereenrolledinthisstudyfromJune2004toSeptember2005．Fourhundredandfifty-fourcaseswererandomlyselectedtobeincludedinthetrainingsamples．andtheremaining230easeswereusedastestingsamples．Using蛐rc—diethylenetriaminepentaaceti

7、cacid(9岬c—DTPA)plasmaclearancebydualplasmasamplingmethodasreferenceGFR(rGFR)，theoriginalabbreviatedMDRDequationWasmodifiedbythefollowingtwomethods．Firstly．aracialfactorforChineseWasaddedtotheoriginalabbreviatedMDRDequation．Secondly，multiplelinearregressionwasappliedtot

8、hetrainingsample，andthecoefficientassociatedwitheachvariableintheoriginalabbreviatedMDRDequationwasmodifiedrespective