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1、肾小球滤过率评估方法的临床适用性比较作者：熊了波，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GFR<60mlomin-lo(1.73m2)-l,B组12例GFR60-90mlomi
2、n-1o(1.73m2)-1,C组19例GFR>90mlomin-1o(1.73m2)-l,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I•分别为0.916(P<0.01),0.847(P<0.01)>及0.873(P<0.01)o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)-l］分别为，A组(23.
3、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方程适用于屮重度肾功能不全者，而改良简化MDRD方程能较好的评价我国慢性肾脏疾病恵者
4、的GFRo【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]:ObjectiveTounderstandtheapplicabilityoftheestimationofglomerularfiltraterate(GFR)byrenaldynamicimage,modifiedabbreviatedMDRDequationandCockcroft-GaultequationinChinesepatientswithchronickidne
5、ydisease(CKD).Method53CKDpatientswerediagnosedaccordingtoK/DOQIguideline.ThepatientsweredividedintothreesubgroupsaccordingtotheGFRobtainedbytwo-samplemethodandthecorrelationbetweenthreemethodswasanalysedrespectively.ResultTherewasnodifferencebetweenthre
6、emethodsandtwo-samplemethod.TheGFR[mlomin-1o(1.73m2)-1]obtainedfromtwo-samplemethod,renaldynamicimaging,Cockcroft・GaultequationandmodifiedabbreviatedMDRDequationwasdisplayedasfollows:groupA(23.6+13.3),(39.3+17.3),(25.1±17.5)and(27.7±12.1),groupB(69.8±9.
7、1),(71.9±10.0),(56.9±13.1)and(72」±14.2),groupC(109.4±13.6),(108.5±20.9),(72.7±15.2)and(89.9+13.2).ConclusionTheGFRmeasuredbythesethreemethodshasexcellentcorrelationswithtwo・samplemethod.Themethodofrenaldynamicimagingwasusedinpatientswithnormalormildinsu
8、fficientofrenalfunction.Cockcroft-Gaultequationwasusedinpatientswithmoderateorseriousinsufficientofrenalfunction.While,modifiedabbreviatedMDRDequationcanreflectrenalfunctionindifferentstagesofCKDinChinese.Keywords:Renaldynamicima
