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目的探讨肾小球滤过率(GFR)多种检测和判断方法评估GFR的准确性和适用性。方法采用99mTc-DTPA肾动态显像法测定235例不同疾病住院患者的总肾GFR(gGFR),比较血清肌酐(Scr)及基于Scr的GFR评估方程(CG公式、简化MDRD公式、CKD-EPI公式)、血清半胱氨酸蛋白酶抑制剂C(Cys C)及基于Cys C的GFR评估方程(Hoek公式、Orebro公式、Le Bricon公式)与gGFR的相关性,用受试者工作特征曲线(ROC)评价多种GFR检测方法的准确性。结果尿酸、尿素氮、Scr、Cys C、CG公式、简化MDRD公式、CKD-EPI公式、Hoek公式、Orebro公式及Le Bricon公式均与gGFR相关(P均<0.01),尤以Cys C及Cys C为基础估算的GFR评估方程相关性最好。结论Cys C及基于Cys C的GFR评估方程在评价GFR准确性和偏差方面优于其他方法,CKD-EPI公式优于简化MDRD公式。
Objective To investigate the accuracy and applicability of multiple detection and assessment of glomerular filtration rate (GFR) in evaluating GFR. Methods 99mTc-DTPA renal dynamic imaging was used to determine the total renal GFR (gGFR) in 235 hospitalized patients with different diseases. The serum creatinine (Scr) and Scr-based GFR assessment equation (CG formula, simplified MDRD formula, CKD-EPI formula ), Serum cystatin C (Cys C) and Cys C-based GFR assessment equation (Hoek formula, Orebro formula, Le Bricon formula) and gGFR, using the receiver operating characteristic curve (ROC) Evaluate the accuracy of multiple GFR assays. Results The uric acid, urea nitrogen, Scr, Cys C and CG formulas, simplified MDRD formula, CKD-EPI formula, Hoek formula, Orebro formula and Le Bricon formula were all related to gGFR (P <0.01) GFR assessment equation based on the best correlation. Conclusions Cys C and Cys C-based GFR assessment equations are superior to other methods in assessing the accuracy and bias of GFR. The CKD-EPI formula is superior to the simplified MDRD formula.