肾小球滤过率智能检测分析系统的研制及临床应用研究

Preparation and clinical application of an intelligent determination and analysis system for glomerular filtration rate

目的研制肾小球滤过率（GFR）智能检测分析系统（GFRBMAS），并探讨其检测GFR的临床应用价值。方法采用VB6．0软件编程，并配置好GFRBMAS。采用”锝“-二乙烯三胺五乙酸（^99Tc^m-DTPA）清除率准确测定79例不同疾病住院患者GFR（Tc-GFR），检测并比较GFRBMAS与日立7170S全自动生化仪所测得的血清肌酐（SCr）、尿素氮（BUN）、血尿酸（Uric）、血清钙（Ca）和血清磷（P）值，同时以GFRBMAS、Robert公式测定或测算GFR（GFRBMAS-GFR、Robert-GFR），以Cockcroft／Gauh公式计算内生肌酐清除率（CG-CCr），所得数据进行相关分析与对比研究。结果两种检测方法测得的SCr、BUN、Uric、Ca、P值差异均无统计学意义（P均〉0．05），且两者均呈显著正相关（P均〈0．01）。肾功能正常组和不全组Robert-GFR、CG-CCr值均明显小于Tc-GFR值，差异有统计学意义（P均〈0．01），而GFRBMAS-GFR值与Tc-GFR值相近。相关分析显示，肾功能不全组及正常组GFRBMAS-GFR、Robert-GFR、CG-CCr与Tc-GFR值均呈显著正相关，与SCr、BUN均呈负相关（P〈0．05或P〈0．01）。结论GFRBMAS-GFR、Robert-GFR、CG-CCr均能在一定程度上准确反映GFR，而GFRBMAS-GFR可代替Tc-GFR应用于临床。

Objective To prepare an intelligent determination and analysis system for renal glomerular filtration rate（GFRBMAS）, and to explore its value in clinical setting. Methods GFRBMAS was prepared by programming with VB 6.0 software. GFR of 79 inhospital patients suffering from the different diseases was determined accurately by using clearance rate of ^99Tc^m-diethylene triamine pentoacetic acid （DTPA） （Tc-GFR）. The serum creatinine （SCr）, blood urea nitrogen （BUN）, serum uric acid （Uric）, serum calcium （Ca） and serum phosphorus （P） were determined with both GFRBMAS and 7170S automatic biochemistry determination apparatus （ititachi）, and the result of GFR was compared with that determined by using GFRBMAS and 7170S automatic biochemical determination apparatus. At the same time GFR was determined by using Robert formula （GFRBMAS-GFR, Robert-GFR）, and creatinine clearance rate was calculated with Cockcroft/Gault formula （CG-CCr）. All the results were compared and analyzed. Results No significant difference of SCr, BUN, Uric, Ca and P values determined by two methods. Robert-GFR and CG-CCr values were significantly lower than Tc-GFR value in the normal renal function group and the renal insuffiency group （P〈0.01） and that of GFRBMAS-GFR was close to that of Tc-GFR and relative analysis showed that the values of GFRBMAS-GFR, Robert-GFR, CG-CCr showed significantly positive correlation with that of Tc-GFR, but negative correlation with values of SCr and BUN （P〈0.05 or P〈0.01）. Conclusion GFRBMAS-GFR, Robert-GFR and CG-CCr could all reflect GFR with accuracy to certain extent and GFRBMAS-GFR can take the place of Tc-GFR in clinical setting.