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1、一种慢性肾衰竭临床分期的新指标：尿.血肌酹比值杨建军崔世维朱晓晖朱静仪钱桐茹【摘要】目的探讨在风浓缩状态下风肌酊浓®(urinecreatinine,Ucr)Hjllll清肌酹浓度(serumcreatinine,Scr)的比值(Ucr/Scr)能否作为肾小球滤过率(glomerularfiltrationrate,GRF)检测的指标，进而作为慢性肾功能衰竭(chronicrenalfailure,CRF)临床分期的指标。方法①先测定内生肌清除率(endogenouscreatinineclearancerate,C
2、cr),然后在尿浓缩状态卜•测定Ucr/Scr,并研究两者的相关性。②测定CRF不同时期病人的Ucr/Scr,根据各时期Ucr/Scr的95%可信区间，得出其分期标准。③将此标准应用于慢性肾功能衰竭不同吋期的患者，得岀其敏感性和特异性。结果①在尿浓缩状态下Ucr/Scr与Ccr有很高的相关性，线性方程为：y=0.7493552x+8.675045,r=0.9027,P<0.01o②Ucr/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
3、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〜；厅功能不全期(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】尿肌肝浓度：血清肌肝浓度；慢性肾功能衰竭；内生肌肝清除率ANewIndexofChronicRenalFailureStages:RatiobetweenUrineandSerumCreatinineYangJian-jun,CuiShi-wei,ZhuXiao-
4、hui,etal.Departmentofnephron,AffiliatedHospitalofNantongUniversity,Nantong225001,China[Abstract]ObjectiveToinvestigatewhethertheratio(Ucr/Scr)betweenurinecreatinine(Ucr)andserumcreatinine(Scr)canberegardedastheexaminationmarkerofglomerularfiltrationrate(GFR),th
5、enastheexaminationmarkerofthestagesofchronicrenalfailure(CRF),whenurinewasconcentrated.Methods①Firstlyendogenouscreatinineclearancerate(Ccr)wasmensurated.SecondlyUcr/Scrwasmensuratedwhenurinewasconcentrated・FinallyUcr/ScrwascomparedwithCc匚②Ucr/Scrwasmensuratedi
6、npatientswithdifferentstagesofCRFandthestandardofUcr/Scrwasacquiredaccordingto95%confidenceintervalofUcr/Scr.(3)ThestandardofUcr/ScrwasusedtoclinicpatientswithdifferentstagesofCRFtolookforitssensitivityandspeciality.Results①TherelativitybetweenUcr/ScrandCcrwass
7、ignificantinurineconcentrationstage.Thelinearequationwasasfollowing:y=0.7493552x+8.675045,r=0.9027,P<0.01.②Thesensitivity(0.8529)andspeciality(0.8382)ofthestandardofUcr/Scrwerebothhigh.ConclusionsUcr/ScrcanberegardedastheexaminationmarkerofGFR,thenastheexaminat
8、ionmarkerofthestagesofCREThestandardofUcr/Scrisasfollowing:naturalpersons(90〜),substitutedstage(50〜)，notsubstitutedstage(20〜)，prostratestage(9〜)，uremiastage(<9).[Keywords]Uc
