肾小球滤过率评估方程在亲属肾移植供者评估中的适用性比较

The application of three kinds of glomerular filtration rate estimation methods in the evaluation and selection of the potential living kidney donors

目的以99mTc-DTPA血浆清除率为标准,对24 h内生肌酐清除率(Ccr)、Cockcroft-Gault(CG)方程和简化MDRD方程进行比较,评价三种方程在评估亲属肾移植供者肾功能中的应用价值。方法选择2004—2010年在我院进行评估的40例亲属肾移植供者,所有患者同步检测99mTc-GFR、血、尿肌酐等,将Ccr、C-G方程和简化MDRD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(99m Tc-GFR)进行比较。结果 Ccr、MDRD-GFR、CG-GFR与99mTc-GFR相关系数r分别为:0.74、0.81、0.86;三种方程的GFR估算值与99mTc-GFR差异均有显著统计学意义(P<0.01)。结论三种方程的GFR估算值与99mTc-GFR均有较好的相关性,其中以C-G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测定值差异均存在显著统计学意义。C-G方程较适合应用于亲属肾移植供者肾功能的初步评价。

Objective To compare 24 h creatinine clearance rate（Ccr） 、Cockcroft-Gault（CG） equation and MDRD（Modification of Diet in Renal Disease） equation in the evaluation and selection strategy of potential living kidney donors.Methods 40 potential living kidney donors were selected.99mTc-DTPA plasma clearance was calculated and standardized by body surface area.GFR estimated with Ccr、CG equation and MDRD equation were compared with 99mTc-DTPA GFR.Results The correlation coefficients for Ccr、CG equation and MDRD equation were 0.74、0.86、0.81.There was statistic difference between GFR estimated with three kinds equation and 99mTc-DTPA GFR（P0.01）.Conclusion There were good correlation coefficients between GFR estimated with three kinds equation and 99mTc-DTPA GFR.The CG equation seems to be the best for GFR estimation,MDRD equation is the second,Ccr is the last.There was significant difference between GFR estimated with three kinds equation and 99mTc-DTPA GFR.These results indicate that the CG equation is better in the evaluation and selection of potential living kidney donors.