不同肾小球滤过率估算公式在老年人肾功能评估中适用性的比较

Comparison of the application of different giomerular filtration rate-estimating formulae in elderly patients

目的比较不同肾小球滤过率估算公式在老年人肾功能状况评估中的适用性及其与内生肌酐清除率（Ccr）的相关性。方法选择720例老年内科患者，应用Cockcroft-Gault（C-G）公式、肾脏病膳食改良试验（MDRD）7（M7）公式、MDRD（Ma）公式及我国改良MDRD（Me）公式计算估计肾小球滤过率（eGFR）。分析C-G公式与其他公式计算的eGFR值与年龄和Ccr值的相关性。结果Ccr值和C-G公式计算的eGFR值均随年龄增长明显下降，与年龄呈显著负相关；其他公式计算的eGFR值与年龄均无相关性。本组患者的总体Ccr值为（50．32±23．64）ml·min-1·（1．73m2）-1；C-G公式计算的eGFR值为（45．45±18．46）ml·min-1·（1．73m2）-1，与Ccr值最为接近；其他公式的测定值均显著高于Cer值。在总体和CKD3～4期患者，C-G公式计算的eGFR值与Ccr值的相关性均高于其他公式。结论C-G公式计算的eGFR值与年龄和Ccr值的相关性最好，C-G公式可代替Ccr评估老年人的肾功能状况。

Objective To compare different formulae of estimated glomerular filtration rate （eGFR） for assessment of renal function in elderly patients and the correlation with creatinine clearance （Ccr）. Methods Seven hundred and twenty elderly patients were enrolled. The eGFR value was computed by using the formulae of Cockcroft-Gault （C-G）, MDRD seventh （M7）, abbreviated MDRD （Ma） and Chinese modified abbreviated MDRD （Mc）. The correlation of eGFR value with age and Ccr value was compared. Results The prevalence of eGFR less than 60 ml . min- 1 . （ 1.73 m2 ） - 1 was 79. 2% in these patients. Ccr value and C-G formula computed eGFR value were negative correlated significantly with age. There was no significant correlation between eGFR value computed by other for- mulae and age. The average Ccr value of these patients was （50. 32 ± 23. 64） ml. min-1. （ 1.73 m2 ） - 1. C-G formula computed eGFR value was （45. 45 ± 18. 46） ml . min- 1 . （ 1.73 m2 ） -1 , and closest to Ccr value. There was significant difference between the eGFR value computed by others with Ccr value. In all patients and CKD stages 3-4, there was a significant positive correlation between eGFR value computed by four formulae with Ccr value,and C-G formula was the best one. Conclusions The correlation between C-G formula computed eGFR value with age is the best, the correlation between C-G formula computed eGFR value with Ccr value is the best. C-G formula seems to replace Ccr to assess the status of renal function in elderly patients.