摘要
目的评价现有在中国人群基础上开发的肾小球滤过率（GFR）评估方程在慢性肾脏病（CKD）患者的适用性。方法选择327例CKD患者，用中国方程、瑞金方程分别预测GFR值，与体表面积标准化^99Tc-DTPA测的GFR（sGFR）进行比较。结果Bland-Altman分析显示瑞金方程估计的GFR和sGFR的一致性最好，但所有方程估计的GFR和sGFR的一致性限度均超过事先规定的专业界值。线性回归结果显示，瑞金方程和MDRD-1方程估测的GFR与X轴的斜率较其他方程更小。在所有方程中，瑞金方程估测GFR 15％符合率、30％符合率和50％符合率均最高，但瑞金方程估测GFR 30％符合率依然低于70％。在CKD的不同分期中，瑞金方程估测GFR 15％符合率、30％符合率和50％符合率均较高。结论当血肌酐的测定方法为酶法时，如果直接应用目前在中国人群基础上开发出的GFR评估方程预测GFR，可能会产生明显的偏差。有必要进行更大规模试验，进一步评估和验证中国方程和瑞金方程在中国人群的适用性。
Objective To evaluate the applicability of modified formulas based on plasma creatinine levels in Chinese patients with chronic kidney disease （CKD）. Methods A total of 327 CKD patients were investigated. Glomerular filtration rate （GFR） was estimated with Chinese equations and Ruijin equation. The accuracy of estimated GFR was compared with ^99Tc- DTPA-GFR （sGFR） in CKD patients. Results Bland-Ahman analysis demonstrated that Ruijin equation was more consistent with sGFR than the other equations. But all the equations were not well consistent with sGFR. Linear regression showed that the slopes of Ruijin equation and MDRD-1 equation were closer to the identical line. 15%, 30% and 50% accuracy of Ruijin equation were higher than the other equations. But 30% accuracy of Ruijin equation was still less than 70%. When the accuracy of estimated GFRs was compared with sGFR in different stages of CKD, GFR estimated by Ruijin equation showed good results. Conclusions When plasma creatinine is checked with enzymatic method, modified GFR estimation equations may show great bias in Chinese CKD patients. More clinical trails should be carried out to evaluate and identify the application of modified GFR estimation equations in Chinese patients with CKD.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2009年第3期165-169,共5页
Chinese Journal of Nephrology
关键词
肾疾病
肾功能不全
慢性
肾小球滤过率
评估方程
Kidney diseases
Renal insufficiency, chronic
Glomerular filtration rate
Estimation equation
