上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (11): 1376-.doi: 10.3969/j.issn.1674-8115.2010.11.014

• 论著（临床研究） • 上一篇    下一篇

基于血清肌酐的肾小球滤过率估算值与99mTc-肾小球滤过率的相关性9

顾红霞1,2, 秦 利2, 傅宏亮3, 王 辉3, 苏 青2   

  1. 上海交通大学 医学院附属新华医院 |1.崇明分院内分泌科, 上海 202150； 2.内分泌科, 3.核医学科, 上海 200092
  • 出版日期:2010-11-25 发布日期:2010-11-29
  • 通讯作者: 苏 青, 电子信箱: dr_suqing@yahoo.com.cn。
  • 作者简介:顾红霞（1976—）, 女, 主治医师, 硕士生；电子信箱: ghxgjj2006@yahoo.com.cn。

Relationship between estimated glomerular filtration rate from serum creatinine and 99mTc-glomerular filtration rate

GU Hong-xia1,2, Qin Li2, FU Hong-liang3, WANG Hui3, SU Qing2   

  1. 1.Department of Endocrinology &|Metabolism, Xinhua Hospital Chongming Branch, Shanghai Jiaotong University School of Medicine, Shanghai 202150, China； 2.Department of Endocrinology &|Metabolism, 3.Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
  • Online:2010-11-25 Published:2010-11-29

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摘要：

目的 分析肾小球滤过率（GFR）公式估算值(eGFR)与99锝－二乙烯三胺五醋酸 (99mTc-DTPA)法测定值（99mTcGFR）的相关性，探讨适合中国慢性肾脏病（CKD）住院患者eGFR的估算方法。方法 选择1 033例慢性肾脏病住院患者作为研究对象，99mTc-DTPA肾动态显像法测定 99mTc-GFR，酶法检测血清肌酐（SCr）水平。采用Cockcroft-Gault公式、肾脏病膳食改良试验（MDRD）公式、简化MDRD公式、中国MDRD公式、中国简化MDRD公式及CKD-EPI公式计算并用体表面积（BSA）校正后得到eGFR，分别以C-G GFR、7GFR、aGFR、c-7GFR4、c-aGFR4和CKD-EPI-GFR表示。分析99mTc-GFR与eGFR的相关性。结果 相关回归分析显示，C-G GFR、7GFR、aGFR、c-7GFR4、c-aGFR4和CKD-EPI-GFR与99mTc-GFR的相关系数（r）分别为0.805、0.797、0.783、0.791、0.777和0.800，与99mTc-GFR偏差值均值分别为－2.46、－14.24、－16.53、－20.92、－22.92和－13.56。患者99mTc-GFR与SCr水平呈近似双曲线的关系。结论 在基于SCr的公式估算得到的eGFR中，C-G GFR与99mTc-GFR的相关程度最高。提示当以酶法SCr测定结果作为数据源时，C-G公式较适合中国CKD住院患者eGFR的估算。

关键词: 肾小球滤过率, 估算的肾小球滤过率, 血清肌酐, Cockcroft-Gault公式, MDRD方程, CKD-EPI方程, 相关性

Abstract:

Objective To analyse the relationship between estimated glomerular filtration rate (eGFR) and 99mTc-glomerular filtration rate (99mTc-GFR), and explore the suitable methods for eGFR of Chinese inpatients with chronic kidney disease (CKD). Methods One thousand and thirty-three inpatients with CKD were selected, 99mTc-GFR was measured by 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) dynamic renal imaging, and serum creatinine (SCr) was determined by enzymatic method. Cockcroft-Gault formula, modification of diet in renal disease (MDRD) equation, abbreviated MDRD equation, MDRD equation for Chinese, abbreviated MDRD equation for Chinese and CKD-EPI equation were employed for calculation and body surface area (BSA) was used for correction of eGFR (C-G GFR, 7GFR, aGFR, c-7GFR4, c-aGFR4 and CKD-EPI-GFR, respectively). The relationship between 99mTc-GFR and eGFR was analysed. Results Correlation regression analysis revealed that the correlation coefficients between C-G GFR, 7GFR, aGFR, c-7GFR4, c-aGFR4, CKD-EPI-GFR and 99mTc-GFR were 0.805, 0.797, 0.783, 0.791, 0.777 and 0.800, respectively, and the differences were -2.46, -14.24, -16.53, -20.92, -22.92 and -13.56, respectively. There was approximate hyperbolic relation between 99mTc-GFR and SCr. Conclusion C-G GFR is most closely related to 99mTc-GFR among eGFR from SCr, C-G formula may be a suitable method for eGFR of Chinese inpatients with CKD when SCr is measured by enzymatic method.

Key words: glomerular filtration rate, estimated glomerular filtration rate, serum creatinine, Cockcroft-Gault formula, MDRD equation, CKD-EPI equation, relationship