中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2012年
9期
530-533
,共4页
肾小球滤过率%99mTc-二乙三胺五乙酸清除率%胱抑素C%成年中国人
腎小毬濾過率%99mTc-二乙三胺五乙痠清除率%胱抑素C%成年中國人
신소구려과솔%99mTc-이을삼알오을산청제솔%광억소C%성년중국인
Glomerular filtration rate%Clearance rate of 99m Tc-diethylene triamine pentaacetic acid%Cystatin C%Adult Chinese
目的 探讨基于血清胱抑素C(SCys C)的成年中国人肾小球滤过率估算公式(SCysCAC)的临床价值.方法 采用前瞻性对照研究方法,选择2011年1月至12月96例非透析肾脏病住院患者,按入院时肾功能分为不全组(RFI,54例)和正常组(RFN,42例),用双血浆法99m Tc-二乙三胺五乙酸(99mTc-DTPA)清除率检测肾小球滤过率( Tc-GFR),同期测定SCys C、血清肌酐(SCr)与尿素氮(BUN),并以SCysCAC、Arnal-Dade、Grubb、Filler、Grubb、Hojs、Larsson、Macisaac、Rule 9个公式估算肾小球滤过率(GFR),对比不同肾功能组各公式肾小球滤过率估算值(eGFR),并分别与Tc-GFR进行相关性分析研究.结果 在RFI或RFN患者中,SCysCAC、Arnal-Dade、Larsson、Rule公式的eGFR(ml·min-1· 1.73 m-2)始终与Tc-GFR接近(RFI组:37.96±32.65、33.69±25.24、34.16±33.65、33.02±30.88比36.21±31.16; RFN组:112.99±39.26、101.86±72.29、102.69±71.78、99.12±69.54比110.54±48.98,均P＞0.05).在RFI或RFN患者中,SCysCAC、Larsson、Arnal-Dade公式的eGFR与Tc-GFR的差值绝对值无统计学差异,三者中以SCysCAC-eGFR与Tc-GFR的差值绝对值最小,表明3个公式的eGFR均能准确反映GFR,而以SCysCAC最佳.相关性分析显示,各公式的eGFR均在一定程度上准确反映了肾小球功能或GFR.结论 SCysCAC公式为快速、准确估算GFR的方法,可在临床上推广使用.
目的 探討基于血清胱抑素C(SCys C)的成年中國人腎小毬濾過率估算公式(SCysCAC)的臨床價值.方法 採用前瞻性對照研究方法,選擇2011年1月至12月96例非透析腎髒病住院患者,按入院時腎功能分為不全組(RFI,54例)和正常組(RFN,42例),用雙血漿法99m Tc-二乙三胺五乙痠(99mTc-DTPA)清除率檢測腎小毬濾過率( Tc-GFR),同期測定SCys C、血清肌酐(SCr)與尿素氮(BUN),併以SCysCAC、Arnal-Dade、Grubb、Filler、Grubb、Hojs、Larsson、Macisaac、Rule 9箇公式估算腎小毬濾過率(GFR),對比不同腎功能組各公式腎小毬濾過率估算值(eGFR),併分彆與Tc-GFR進行相關性分析研究.結果 在RFI或RFN患者中,SCysCAC、Arnal-Dade、Larsson、Rule公式的eGFR(ml·min-1· 1.73 m-2)始終與Tc-GFR接近(RFI組:37.96±32.65、33.69±25.24、34.16±33.65、33.02±30.88比36.21±31.16; RFN組:112.99±39.26、101.86±72.29、102.69±71.78、99.12±69.54比110.54±48.98,均P＞0.05).在RFI或RFN患者中,SCysCAC、Larsson、Arnal-Dade公式的eGFR與Tc-GFR的差值絕對值無統計學差異,三者中以SCysCAC-eGFR與Tc-GFR的差值絕對值最小,錶明3箇公式的eGFR均能準確反映GFR,而以SCysCAC最佳.相關性分析顯示,各公式的eGFR均在一定程度上準確反映瞭腎小毬功能或GFR.結論 SCysCAC公式為快速、準確估算GFR的方法,可在臨床上推廣使用.
목적 탐토기우혈청광억소C(SCys C)적성년중국인신소구려과솔고산공식(SCysCAC)적림상개치.방법 채용전첨성대조연구방법,선택2011년1월지12월96례비투석신장병주원환자,안입원시신공능분위불전조(RFI,54례)화정상조(RFN,42례),용쌍혈장법99m Tc-이을삼알오을산(99mTc-DTPA)청제솔검측신소구려과솔( Tc-GFR),동기측정SCys C、혈청기항(SCr)여뇨소담(BUN),병이SCysCAC、Arnal-Dade、Grubb、Filler、Grubb、Hojs、Larsson、Macisaac、Rule 9개공식고산신소구려과솔(GFR),대비불동신공능조각공식신소구려과솔고산치(eGFR),병분별여Tc-GFR진행상관성분석연구.결과 재RFI혹RFN환자중,SCysCAC、Arnal-Dade、Larsson、Rule공식적eGFR(ml·min-1· 1.73 m-2)시종여Tc-GFR접근(RFI조:37.96±32.65、33.69±25.24、34.16±33.65、33.02±30.88비36.21±31.16; RFN조:112.99±39.26、101.86±72.29、102.69±71.78、99.12±69.54비110.54±48.98,균P＞0.05).재RFI혹RFN환자중,SCysCAC、Larsson、Arnal-Dade공식적eGFR여Tc-GFR적차치절대치무통계학차이,삼자중이SCysCAC-eGFR여Tc-GFR적차치절대치최소,표명3개공식적eGFR균능준학반영GFR,이이SCysCAC최가.상관성분석현시,각공식적eGFR균재일정정도상준학반영료신소구공능혹GFR.결론 SCysCAC공식위쾌속、준학고산GFR적방법,가재림상상추엄사용.
Objective To probe the clinical value of estimated glomerular filtration rate (GFR) formulas for adults Chinese based on the serum cystatin C (SCys C,SCysCAC).Methods GFRs for 96 cases of patient in hospital suffering from the kidney diseases without dialysis from January to December in 2011 were measured using clearance rate of 99m Tc-diethylene triamine pentaacetic acid ( 99m Tc-DTPA,Tc-GFR ) by prospective control study method.Based on the renal function,96 patients were sorted into renal function insufficient group (RFI,n=54) and renal function normal group (RFN,n =42).The SCys C,serum creatinine (SCr) and blood urea nitrogen (BUN) were measured at the same day for calculating GFRs simultaneously by nine formulas such as SCysCAC,Arual-Dade,Grubb,Filler,Grubb,Hojs,Larsson,Macisaac,Rule etc.The comparision were performed for the estimated GFRs (eGFRs) of renal insufficiency patients and those with normal renal function and the correlation analysis were done betweenthe calculations and Tc-GFR respectively.Results eGFRs (ml· min 1·1.73 m-2) calculated by SCysCAC,Arnal-Dade,Larsson and Rule formulae always were close to those of Tc-GFR and that were 37.96 ± 32.65,33.69 ± 25.24,34.16 ±33.65,33.02 ±30.88 vs.36.21 ±31.16 in RFI group,112.99 ±39.26,101.86 ±72.29,102.69 ±71.78,99.12 ±69.54 vs.110.54 ± 48.98 in RFN group (all P＞0.05 ).The absolute value difference between eGFR by SCysCAC,Larsson and Arnal-Dade formulae and Tc-GFR in RFN or RFI group showed no significant change and the absolute value of the value difference between SCysCAC-eGFR and Tc-GFR was the least among the three absolute values and showed that eGFRs from the three formulas could all reflect the GFR accurately and the SCysCAC formula was the best.The correlation analysis showed the eGFRs from every formula could all to sone extent reflect the glomerular function or GFR accurately.Conclusion The SCysCAC formula was a quickly and accurate method for estimating GFR and may apply clinically.
