不同公式估算慢性肾脏病患者肾小球滤过率的结果评价

Comparative study of evaluating glomeralar filtration rate by different equations

目的探讨不同估算公式估算慢性肾脏病（CKD）患者肾小球滤过率（GFR）在肾功能评价中的价值。方法选择CKD患者239例，所有患者同步检测99锝-二乙烯三胺五乙酸（^99mTc-DTPA）、GFR、血肌酐（SCr）等。将^99mTc-DTPA测定的GFR作为参照，并用肾脏病膳食改良试验（MDRD）公式、Cockcroft-Gault公式、简化MDRD公式及慢性肾脏病流行病合作研究（cKD-EPI）公式计算估测GFR，比较不同CKD分期中各估算公式估算的GFR的准确性。结果各估算公式估算的GFR值均高于^99mTc-DTPA，MDRD公式偏离程度最大；各估算公式估算的GFR值与^99mTc-DTPA检查的GFR结果有相关性，CKD-EPI公式相关性最高。结论CKD-EPI公式估算肾功能更接近^99mTc-DTPA的结果，但仍需进一步校正。

Objective To investigate the value of different equations to predict glomerular filtration rate （GFR） in Chinese adult patients with chronic kidney disease. Methods 239 patients with CKD from March 2008 to December 2010 in Nanjing Drum Tower Hospital were subjected to ^99mTc- DTPA GFR detection, serum creatinine （SCr） test, etc. GFR was estimated by using MDRD, Cock- croft Gault, simplified MDRD and CKD-EPI equations. The accuracy of estimated GFR was compared with ^99mTc-GFR in different stages of CKD. Results The estimated GFR by using MDRD,Cockcroft Gault, simplified MDRD and CKD-EPI equations was higher than that detected by ^99mTc-DTPA. The bias of MDRD equation was the greatest. The estimated GFR by using MDRD,Cockcroft-Gault, simplified MDRD and CKD-EPI equations was correlated with that detected by ^99mTc-DTPA. Conclusion The estimated renal function by CKD-EPI formula is closer to that detected by ^99mTc-DTPA, but still needs further correction.