摘要
目的:以99mTc-DPTA血浆清除率为标准,对24h内生肌酐清除率(Ccr)、Cockcroft-Gault(CG)方程和简化MDRD(modification of diet in renal disease)方程进行比较,评价三种方程在慢性肾脏疾病(CKD)患者中的应用。方法:选择139例各种慢性肾脏疾病患者,将Ccr、CG方程和简化MDRM方程估算的肾小球滤过率(GFR)用体表面积(BSA)标准化,与BSA标准化的99mTc-DTPA测得的GFR(99mTc-GFR)在不同CKD分期进行比较。结果:CKD第一至第五期:Ccr与99mTc-GFR相关系数r分别为:0.79、0.71、0.64、0.59、0.52;Ccr在ROC曲线下面积平均为0.79。CG-GFR与99mTc-GFR相关系数r分别为:0.85、0.78、0.72、0.67、0.61;CG-GFR在ROC曲线下面积平均为0.83。MDRD-GFR与99mTc-GFR相关系数r分别为:0.83、0.76、0.69、0.65、0.59;MDRD-GFR在ROC曲线下面积平均为0.82。在CKD不同分期三种方程的GFR估算值与99mTc-GFR差异均有显著意义(P均<0.001)。结论:三种方程的GFR估算值与99mTc-GFR均有较好的相关性和ROC曲线下面积,以CG方程最好,其次为简化MDRD方程,Ccr最低,但三种方程估算值与99mTc-GFR测定值差异均有显著意义。上述方程直接应用于我国CKD患者时,应对其进行适当修正。
Objective：Objective To compare 24 h creatinine clearance rate （Ccr） ,Cockcroft - Gault （CG） equation and abbreviated MDRD（ Modification of Diet in Renal Disease）equation in glomerular filtration rate （GFR） predication in Chinese patients with chronic kidney disease （CKD）. Methods： 139 patients with CKD were selected. ^99mTc- DTPA plasma clearance was calculated and standardized by body surface area. GFR estimated with Ccr,CGequation and abbreviated MDRD equation were compared with ^99mTc - GFR in different stages of CKD. Results： From the first to fifth stage of CKD, the correlation coefficients for Ccr were 0. 79,0. 71,0. 64,0. 59,0. 52 respecfiuerg, the mean area under RCI2 curve of Ccr was 0.79; the correlation coefficients for CG- GFR were 0. 85,0. 78,0. 72,0. 67,0. 61 respeefiuerg, the mean area under ROC curve of CG - GFR was 0.83 ; the correlation coef- ficients for MDRD- GFR were 0. 83,0. 76,0. 69,0. 65 ,0. 59, the mean area under ROC curve of MDRD - GFR was 0.82. There was significant difference between GFR estimated with three kinds equation and ^99mTC- GFR in different stages of CKD （all P〈 0.01 ）. Conclusion：The correlation coefficients and area under ROC curve between GFR estimated with three kinds equation and ^99mTC -- GFR is the best. The CG equation seems to be the best for GFR estimation, abbreviated MDRD equation is the second,Ccr is the last. There was significant difference between GFR estimated with three kinds equation and ^99mTC -- GFR in different stages of CKD. These results indicate that three kinds equation and its modifications for estimation of GFR should be amended when apply to Chinese patients with CKD in clinical practice.
出处
《中国中西医结合肾病杂志》
2007年第11期645-647,共3页
Chinese Journal of Integrated Traditional and Western Nephrology
