改良简化MDRD方程计算肾小球滤过率的影响因素研究

Influential factors of eGFR calculated by modified MDRD equation

目的探讨全国肾小球滤过率(GFR)课题协作组改良简化MDRD方程计算所得估算GFR(eGFR)的影响因素。方法选择70例慢性肾衰竭(CRF)患者及67名健康人,分别检测血清肌酐、胱抑素C、血尿素氮、血尿酸、血钾、血钠、血氯、血钙、血清白蛋白、血红蛋白,并测定心率、平均肱动脉压、BMI、体表面积、尿比密、24 h尿蛋白定量,记录受测者性别、年龄,用改良简化MDRD方程计算eGFR。对各临床指标与eGFR的关系行直线相关分析及多元回归分析。结果正常人的eGFR分别与血清肌酐、胱抑素和年龄呈负相关(P<0.05或0.01)。CRF患者eGFR仅与血清肌酐、胱抑素C有关(P均<0.01)。慢性肾小球肾炎引致CRF患者及其他病因引致CRF患者的eGFR均与血清肌酐、胱抑素呈负相关(P均<0.01)。结论对于慢性肾衰竭患者及健康人,血清肌酐及胱抑素C均为影响eGFR的重要因素。

Objective To investigate the influential factors of GRF （eGFR） calculated by the modified Modification of Diet in Renal Disease （MDRD） equation. Methods Seventy patients with chronic renal failure （CRF） and sixty-seven healthy subjects were recruited in this study. Serum Cr, SCy-C, BUN, UA, potassium, sodium, chlorine, calcium, SAlb and hemoglobin were detected. Heart rate, mean brachial blood pressure, body mass index, body surface area, urine specific gravity, 24 h urine protein quantization were measured. Gender and age of all participants were recorded, eGFR was calculated by modified MDRD equa- tion. Linear correlation and multivariate regression analysis between eGFR and clinical factors were analyzed. Results For healthy controls, eGFR was negatively correlated with SCr, SCy-C and age （P 〈 0. 05 or P 〈 0. 01 ）. For CRF patients, eGFR was negatively associated with SCr and SCy-C （ both P 〈 0. 01 ） For CRF patients induced by CGN and alternative causes, eGFR was negatively correlated with SCr and SCy-C （ all P 〈 0. 01 ）. Conclusion For both CRF and normal subjects, SCr and SCy-C act as pivotal influential factors affecting eGFR.