肾小球滤过测算公式在慢性肾脏病中的应用评估

Validation of the value of indirect renal function estimation formulas in Chinese people

目的以肾小球滤过率(GFR)为标准,评价Jelliffe公式、Cockcroft-Gault公式、简化MDRD(modified diet inrenal disease study)公式以及吴锡信公式在评估肾功能损伤中的价值。方法选择180例做GFR测定的非透析患者,以Jelliffe公式、简化MDRD公式及吴锡信公式推算GFR,以Cockcroft-Gault公式推算肌酐清除率,通过方差分析比较各推算值与GFR的差异及相关关系。结果Cockcroft-Gault公式及吴锡信公式推算值均与肾小球滤过率值有显著性差异(P=0.00)。Jelliffe公式、简化MDRD公式推算值仅在GFR<60 ml.min-1.(1.73 m2)-1时与肾小球滤过率无显著性差异,但与GFR相关性不好。结论Cockcroft-Gault公式及吴锡信公式不适用于评价中国人肾功能受损的情况。Jelliffe公式、简化MDRD公式仅在GFR<60 ml.min-1.(1.73 m2)-1时可用于粗略评价中国人肾小球滤过功能受损情况。

Objective Using glomerular filtration rate as a standard, to evaluate the Jelliffe formula, the Cockcroft-Gault formula, the simplified MDRD formula and the Wu Xixin formula in estimating renal function in Chinese subjects. Methods One hundred and eighty patients with glomerular filtration tand without hemodialysis were included. Renal function estimates by using the Jelliffe formula, the Cockcroft-Gault formula, the simplified MDRD formula and the Wu Xixin formula were compared with glomerular filtration rate. Results The values of the Cockcroft-Gault formula and the Wu Xixin formula were significantly different from that of glomerular filtration rate （P = 0.00）. Value of the Jelliffe formula and the simplified MDRD formula were not significantly different from the glomerular filtration rate value when the glomerular filtration rate was lower than 60 ml/min/1.73 m^2. Conclusion Only when the glomerular rate is lower than 60 ml/min/ 1.73 m^2, can the Jelliffe formula and the simplified MDRD formula be used for estimating the glomerular filtration rate in the Chinese people. The Cockeroft-Gault formula and the Wu Xixin formula were not suitable for estimating the glomerular filtration rate in the Chinese patients.