三种肾小球滤过率评估方程评估糖尿病肾病与肾功能的比较

The Application of Different Estimating Equations for Glomerular Filtration Rate in Type 2 Diabetes

目的评价在我国2型糖尿病患者中Cockcroft-Gauh方程、MDRD方程及MCQ方程的适用性。方法选择2006年1月-2007年11月经^99mTc-DTPA测定肾小球滤过率（GFR）的2型糖尿病患者共502例，分别采用以上三个方程估算GFR并与同位素结果进行比较。结果入选的2型糖尿病患者中男性248名，年龄（59．4±11．7）岁．体质指数（24．7±3．8）kg／m2，血肌酐68μmol／L，范围为56～82μmol／L，经^99mTc-DTPA测定的GFR为（70．3±21．5）ml／（min’m^2）。C0ckcroft-Gauh方程的估算值为（91．2±30．0）ml（min·m^2），MDRD方程的估算值为（96．9±28．2）ml／（min·m2。），MCQ方程的估算值为（99．2±21．5）ml／（min·m^2），方程的决定系数Rz值分别为0．569、O．520、0．466，各方程估算的GFR的准确性和精确性都不太高，但相比较而言，Cockcroft-Gauh方程优于其他两个方程。结论三个方程估算GFR均存在不足之处，但由于目前尚缺乏专门针对糖尿病人群的评估方程，在临床实际工作中采用Cockcroft-Gault方程来评估2型糖尿病患者的GFR不失为一个简便实用的方法。

Objective To evaluate the application of Cockcrofi-Gauh, MDRD and MCQ equations in Chinese type 2 diabetes. Methods 502 of type 2 diabetic patients whose GFR was measured using ^99mTc-DTPA were enrolled in this study from January 2006 to November 2007. The comparisons were made among these three estimating equations. Results There were 248 male in this study, the age was （59.4±11.7） years, body mass index was （24.7±3.8） kg/m^2, serum creatinine was 68 p.mol/L, and GFR measured using ^99mTc-DTPA was （70.3±21.5） ml/（min .m^2）. The estimated GFR from Cockcroft-Gault equation was （91.2＋30.0） roll（min-m^2）, the estimated GFR from MDRD equation was （96.9±28.2） ml/（min.m^2 ）, and the estimated GFR from MCQ equation was （99.2±21.5） ml/（min.m^2）. The R2 for the equations above were 0.569, 0.520 and 0.466, respectively. All the estimating equations showed a lower degree of precision and accuracy, but Cockcroft-Gault equation showed a little better than the others. Conclusion These equations all had some deficiencies in estimating GFR, but in clinical work it is more convenient and practical to use Cockcroft-Gauh equation to estimate GFR in Chinese type 2 diabetes.