四种肾小球滤过功能测定方法的评估分析

Evaluation of 4 kinds of glomerular filtration rate measurement method

目的 评估测定肾小球滤过功能的各种方法。方法 以99mTc DTPA清除率 (CL99mTc)为标准 ,用受试者工作特征曲线 (ROC)分析及相关回归分析评定碘海醇清除率 (CLIoh)、4小时内生肌酐清除率 (4hCcr)、生物电阻抗瘦体重法肌酐清除率 (LBWCcr)、Cockcroft Gault肌酐清除率 (CkCcr)检测肾小球滤过功能的准确性。结果 35例患者结果显示CLIohROC曲线下面积平均为 0 98;4hCcrROC曲线下面积平均为 0 91;LBWCcrROC曲线下面积平均为 0 94 ;CkCcrROC曲线下面积平均为0 89。CLIoh、4hCcr、LBWCcr、CkCcr与CL99mTc相关系数分别为 0 98、0 88、0 92、0 90 ,回归系数分别为1 0 3、0 71、0 95、0 91。结论 CLIoh准确性最好 ,LBWCcr准确性仅次于CLIoh并且简便、重复性好 ,4hCcr准确性居第三位 ,但结果偏高 ,CkCcr亦较准确、有一定的实用性并且最为简便。

Objective To evaluate different methods in glomerular filtration rate measurements Methods Using clearance of 99m Tc DTPA (CL 99m Tc) as the standard method, we compared the clearance of iohexol (CLIoh), 4 hours endogenous creatinine clearance (4 h Ccr), lean body weight creatinine clearance (LBWCcr) and Cockcroft Gault creatinine clearance (CkCcr) using Receiver operating characteristic (ROC) curve, correlation and regression analysis Results The mean area under ROC curve of CLIoh, 4 h Ccr, LBWCcr and CkCcr from 35 patients were 0 98, 0 91, 0 94, and 0 89, respectively The correlation coefficients for CLIoh, 4 h Ccr, LBWCcr and CkCcr were 0 98, 0 88, 0 92 and 0 90, respectively The regression coefficients for CLIoh, 4 h Ccr, LBWCcr and CkCcr were 1 013, 0 71, 0 95, and 0 91, respectively Conclusions The accuracy of CLIoh was the best The accuracy of LBWCcr was better than that of 4 h Ccr and CkCcr LBWCcr was simple and reproducible The accuracy of 4 h Ccr was good but it yielded higher values than that of the standard method CkCcr was also good and it was the simplest method