采样时间对碘海醇清除率测定肾小球滤过率的影响研究

The effect of different sampling time on dual-plasma-sample method in determination of iohexol clearance

目的比较不同采样时间对碘海醇清除率测定肾小球滤过率(GFR)的影响,确定双血浆法准确性较好的采血时间点。方法入选北京大学人民医院自2015年10月至2016年9月收治的肾脏病患者78例,同时选取40名健康志愿者作为对照组。所有受试者单次注射碘海醇5 m L后于2 h、3 h、4 h静脉采血,采用高效液相色谱法检测血浆碘海醇浓度并计算GFR。以多点采血结果 MPSM-GFR为参考标准,比较双血浆法DPSM-GFR与其相关性和一致性。结果双血浆法GFR23、GFR34、GFR24与MPSM-GFR的相关系数R分别为0.990、0.971、0.999,平均偏差为(-0.95±4.76)mL/(min·1.73m^2)、(0.39±8.94)mL/(min·1.73m^2)、(-0.59±1.65)mL/(min·1.73m^2),位于MPSMGFR±5%范围内值的个数和比例分别为86(72.88%)、72(61.02%)、117(99.15%)。结论双血浆法GFR24与MPSMGFR一致性最好,在2 h、4 h两个时间点采血可代替三点采血结果以减少采血次数。

Objective Compare the effect of different sampling time on dual-plasma-sample method in determination of iohexol clearance to find the optimal sampling time of DPSM. Methods 40 healthy volunteers and 78 patients with kidney disease were enrolled, blood samples were drawn after a single-injection of 5mL iohexol at 2 h, 3 h and 4 h. Iohexol concentration was detected by HPLC to calculate GFR. The agreement and accuracy between DPSM-GFRs and MPSM-GFR were compared. Results The agreement between GFR23, GFR34j GFR24 and MPSM-GFR were 0.990, 0.971, 0.999 respectively, mean difference were （-0.95±4.7 6 ）mL/ （min. 1.73m^2）, （ 0.39±8.94 ）mL / （min.1.73m^2）, （-0.59±1.65 ）mL / （min. 1.73m2） respectively. Correlation The sampling time of DPSM at 2 h and 4 h showed the best agreement and accuracy with MPSM-GFR.