老年慢性肾脏病人肾小球滤过率检测方法的探讨

Exploration of the Testing Method of Glomerular Filtration Rate in Old-aged Patients with Chronic Kidney Disease

目的评价肾小球滤过率(GFR)评估方程在我国老年慢性肾脏病(CKD)患者肾功能检测中的适用性.方法选择72例老年慢性肾脏病患者,将Cockcroft-Gault方程、MDRD7方程、简化MDRD方程计算的GFR值用体表面积(BSA)标准化,与BSA标准化的99mTc-DTPA测得的GFR在不同CKD分期进行比较.结果方程计算的GFR(cGFR、7GFR、aGFR)与99mTc-GFR(sGFR)均具有显著的相关性,相关性较好的依次为MDRD7、简化MDRD、Cockcroft-Gault方程;在Roc曲线下的平均面积上述3个公式分别是0.82、0.78和0.77.cGFR、7GFR、aGFR与99mTc-GFR差异均有显著意义(P<0.01).结论上述方程用于我国老年CKD患者时,应对其进行适当修正.

Objective To evaluate the applicability of three equations in Chinese old-aged patients with chronic kidney disease （CKD）. Methods CKD were diagnosed according to K/DOQI guideline. 72 patients with CKD were selected. Glomerular filtration rates （GFRS） estimated with MDRD seven equation, abbreviated MDRD equation, and Cockcroft-Gauh （CG） equation were compared with ^99mTc-DTPA plasma clearance （sGFR） in different stages of CKD. The GFRs were standardized by body surface area. Results The GFRs of the three equations were correlated significantly with sGFR. MDRD seven equation seemed to be the best for GFR estimation, abbreviated MDRD equation was the second, CG equation was the last. The mean area under Roc curve of MDRD seven equation, abbreviated MDRD equation and CG equation was 0.82, 0.78and 0.77 respectively. Conclusion The three equations for estimation of GFR should be amended when applying to Chinese old-aged patients with CKD.