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1、中国中西医结合肾病杂志2008年6月第9卷第6期CJITWN,June2008,Vol.9,No.6#517#7种肾小球滤过率评估方程在慢性*肾脏病患者中的比较¹俞岗¹汪年松¹v崔勇平¹刘华º王蕾º张晓光1摘要2目的:比较不同肾小球滤过率(GFR)评估方程在慢性肾脏病(CKD)患者中的诊断价值。方法:选择CKD各期患者108例,对照20例,应用ELISA法测定血清CystatinC浓度、99mTc-DTPA清除率测定GFR、全自动生化分析仪检测血清肌酐(Scr),并用7种公式计算GFR(eGFR)
2、。结果:在CKD2期,MDRD、简化MDRD与GFR比较有统计学差异,在CKD3期,CG-eGFR与GFR比较有统计学差异。而Cys-eGFR在CKD1~5期与GFR均无统计学差异。在CKD2期、3期,4种Cys-eGFR方程与GFR的相关性均显著优于CG和MDRD公式。而在1期、4期和5期,各方法测定eGFR与同位素GFR的相关性相当。在GFR<60ml#min-1#1.73m-2的CKD患者中,4种Cys-eGFR的ROC曲线下面积大于Cr-eGFR方程,有统计学意义;在GFR<30ml#mi
3、n-1#1.73m-2的CKD患者中,ROC曲线下面积比较无统计学差异。结论:cys-eGFR在肾功能轻中度减退的患者中,优于CG和MDRD,在肾衰竭后期,诊断价值同Cr-eGFR公式。1关键词2肾小球滤过率评估方程慢性肾脏病MDRD方程Cockcrof-Gault方程基于半胱氨酸蛋白酶抑制剂C的方程ComparativeStudyofEstimatingGlomerularFiltrationRatebySevenCalculationMethodsinPatientswithChronicKi
4、dneyDiseaseZHANGXiaoguang,YUGang,WANGNiansong,etalDepartmentofNephrology,ShanghaiSixthPeople.sHospital,AffiliatedtoShanghaiJiaotongUniversity,Shanghai(200233)ABSTRACTObjective:TocomparethevalueofdiagnosisofsevenGFRequationsinpatientswithchronickidneyd
5、isease.Methods:108caseswithchronickidneydiseaseand20casesnormalpeoplewereselected,serumcystatinCconcentrationwerede-tectedbyusingthemethodofenzymelinkedimmunosorbentassay(ELISA).Glomerularfiltrationrate(GFR)wasestimatedbytheplasmaclearanceof99mTc-DTPA
6、andserumcreatinine(Scr)wasdetectedsimultaneouslyusingAutomeficbiochemicstryAnalyzer.EstimateGFR(eGFR)wasestimatedwithsevencalculationmethods.Results:TherewerestatisticdifferencesbetweenModificationofDietinRenalDisease(MDRD)equations,simplifiedMDRDequa
7、tionandGFRinthegroupsCKD2.Thereexistsstatisticdiffer-encesbetweentheCockcroft-GaultequationandGFRinthegroupsCKD3;Therewasnostatisticdifferencesbetweenfourcys-tatinCbasedequations(glomerularfiltrationrateestimatedviacystatinformula[Cys-eGFR])andGFRfrom
8、CKD1~5.InthegroupCKD2and3,fourkindsofformulaCys-eGFRandandGFRareallsuperiortoCGandMDRD.InthegroupCKD1、4and5,allmethodsarecomparativeinthemeasuringbetweenGFRandisotopeGFR.TestingCDKpatientswithGFR<60ml#min-1#1.73m-2,fourkindsofROCcurveareaofCys
