中华生物医学工程杂志
中華生物醫學工程雜誌
중화생물의학공정잡지
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
2011年
1期
29-33
,共5页
赖德源%方颖璇%任玥%徐安平%张益民
賴德源%方穎璇%任玥%徐安平%張益民
뢰덕원%방영선%임모%서안평%장익민
肾小球滤过率%半胱氨酸蛋白酶抑制剂C%肌酐%慢性肾脏病%准确性
腎小毬濾過率%半胱氨痠蛋白酶抑製劑C%肌酐%慢性腎髒病%準確性
신소구려과솔%반광안산단백매억제제C%기항%만성신장병%준학성
Clomemlar filtration rate%Cystatin C%Creatinine%Chronic kidney disease%Accuracy
目的 验证2008年美国CKD-EPI基于半胱氨酸蛋白酶抑制剂C(cystatinc)开发的肾小球滤过率(GFR)评估方程在中国慢性肾脏病(CKD)患者的适用性.方法 选择2008年12月至2009年4月中山大学附属第二医院68例非透析CKD患者,用体表面积标准化Cockcroft-Ganh方程、简化MDRD方程、改良后简化MDRD方程、肾动态显像以及2008年美同CKD-EPI基于eystatin C开发的3条GFR评估方程计算的GFR(分别为cGFR、aGFR、mGFR、gGFR、CyslGFR、Cys2GFR、Cys3GFR),与双血浆法99mTc-DTPA血浆清除率测定的GFR(即tGFR)进行比较分析.结果 Pearson相关分析显示,7种方法GFR估计值与tGFR明显相关,相关系数从大到小依次为Cys3GFR(0.93)、gGFR(0.91)、mGFR(0.89)、Cys2GFR(0.88)、CyslGFR(0.85)、cGFR(0.85)、aGFR(0.83).在准确性比较中,Cys3GFR较aGFR、CysIGFR准确性高.Bland.Altman分析显示Cys3GFR估计值与tGFR的一致性最好,其一致性限度未超过事先规定的专业界值.线性同归结果显示mGFR偏差最小,精确度最高.结论 cystatin C联合肌酐并包括人口统计学参数的方程(Cys3GFR)应用于中国CKD患者准确性较高,与tGFR相关性和一致性最好.且优于仅包括cystatin C GFR估评方程(CyslGFR)、Cockcrofi-Gauh方程、简化MDRD方程.
目的 驗證2008年美國CKD-EPI基于半胱氨痠蛋白酶抑製劑C(cystatinc)開髮的腎小毬濾過率(GFR)評估方程在中國慢性腎髒病(CKD)患者的適用性.方法 選擇2008年12月至2009年4月中山大學附屬第二醫院68例非透析CKD患者,用體錶麵積標準化Cockcroft-Ganh方程、簡化MDRD方程、改良後簡化MDRD方程、腎動態顯像以及2008年美同CKD-EPI基于eystatin C開髮的3條GFR評估方程計算的GFR(分彆為cGFR、aGFR、mGFR、gGFR、CyslGFR、Cys2GFR、Cys3GFR),與雙血漿法99mTc-DTPA血漿清除率測定的GFR(即tGFR)進行比較分析.結果 Pearson相關分析顯示,7種方法GFR估計值與tGFR明顯相關,相關繫數從大到小依次為Cys3GFR(0.93)、gGFR(0.91)、mGFR(0.89)、Cys2GFR(0.88)、CyslGFR(0.85)、cGFR(0.85)、aGFR(0.83).在準確性比較中,Cys3GFR較aGFR、CysIGFR準確性高.Bland.Altman分析顯示Cys3GFR估計值與tGFR的一緻性最好,其一緻性限度未超過事先規定的專業界值.線性同歸結果顯示mGFR偏差最小,精確度最高.結論 cystatin C聯閤肌酐併包括人口統計學參數的方程(Cys3GFR)應用于中國CKD患者準確性較高,與tGFR相關性和一緻性最好.且優于僅包括cystatin C GFR估評方程(CyslGFR)、Cockcrofi-Gauh方程、簡化MDRD方程.
목적 험증2008년미국CKD-EPI기우반광안산단백매억제제C(cystatinc)개발적신소구려과솔(GFR)평고방정재중국만성신장병(CKD)환자적괄용성.방법 선택2008년12월지2009년4월중산대학부속제이의원68례비투석CKD환자,용체표면적표준화Cockcroft-Ganh방정、간화MDRD방정、개량후간화MDRD방정、신동태현상이급2008년미동CKD-EPI기우eystatin C개발적3조GFR평고방정계산적GFR(분별위cGFR、aGFR、mGFR、gGFR、CyslGFR、Cys2GFR、Cys3GFR),여쌍혈장법99mTc-DTPA혈장청제솔측정적GFR(즉tGFR)진행비교분석.결과 Pearson상관분석현시,7충방법GFR고계치여tGFR명현상관,상관계수종대도소의차위Cys3GFR(0.93)、gGFR(0.91)、mGFR(0.89)、Cys2GFR(0.88)、CyslGFR(0.85)、cGFR(0.85)、aGFR(0.83).재준학성비교중,Cys3GFR교aGFR、CysIGFR준학성고.Bland.Altman분석현시Cys3GFR고계치여tGFR적일치성최호,기일치성한도미초과사선규정적전업계치.선성동귀결과현시mGFR편차최소,정학도최고.결론 cystatin C연합기항병포괄인구통계학삼수적방정(Cys3GFR)응용우중국CKD환자준학성교고,여tGFR상관성화일치성최호.차우우부포괄cystatin C GFR고평방정(CyslGFR)、Cockcrofi-Gauh방정、간화MDRD방정.
Objective To verify the adaptability of CKD-EPI equation developed based on cystatin C in America in 2008 among Chinese patients with chronic kidney disease (CKD).Methods Between December 2008 and April 2009, 68 non - dialysis CKD patients were recruited and calculated for their glomerular filtration rates(GFRs) by Cockcroft-Gault equation, simplified MDRD equation, modified MDRD equation and gates method with 99mTc-DTPA (cGFR, aGFR, mGFR, gGFR) and three CKD-EPI estimating equations developed based on cystatin C (CyslGFR, Cys2GFR, Cys3GFR).All the results above were then compared and analyzed with tGFR determined by double plasma sample method of GFR with 99mTc-DTPA.Results Pearson analysis demonstrated that seven estimated GFRs (cGFR, aGFR, mGFR, gGFR,cyslGFR, cys2GFR, cys3GFR) were significantly correlated with tGFR, with Cys3GFR showing the highest correlation coefficient (0.93) , followed by gGFR (0.91) , mGFR (0.89) , Cys2GFR (0.88) , CyslGFR (0.85), cGFR(0.85), and aGFR(0.83).Cys3GFR yielded results that were more accurate than did aGFR or CyslGFR.Bland-Altman analysis demonstrated that Cys3GFR had the best consistency with tGFR which did not exceed the predetermined limits.The outcome of linear regression showed that the modified MDRD equation had the least deviation and the highest precision.Conclusion In Chinese population, the third CKD-EPI equation (Cys3GFR) including cystatin, creatinine and demographic statistics has favorably greater accuracy, and best consistency and correlation with tGFR, as compared with the first CKD-EPI equation based on cystatin C alone, Cockcroft-Gault equation or simplified MDRD equation.
