CAJ | 학술논문

目的：分析评价美国慢性肾脏病（CKD）流行病合作工作组（CKD‐EPI）开发方程在 CKD 患者病情评估中的作用。方法2012年1月至2014年4月湖北省中医院肾病门诊260例 CKD 患者，用 CKD‐EPI 开发方程计算肾小球滤过率（GFR）（EPI‐GFR），同 CKD 患者血肌酐（Cr）、尿酸（UA）、清蛋白（ALB）、钙（Ca）、磷（P）、胱抑素 C（CysC）、24 h 尿蛋白（UP）、血红蛋白（Hb）等生化指标比较，并与简化肾脏病饮食改良（MDRD）方差计算的 eGFR（简化‐GFR）和中国人校正的 MDRD 方程计算的 eGFR（校正‐GFR）进行比较。结果 EPI‐GFR 与 Cr 、UA 、CysC 、P 及24 h UP 呈显著负相关（P ＜0．05），与 Hb 差异有统计学意义（P＜0．05），呈显著正相关，随着病程进展，GFR 逐渐下降，患者贫血也逐渐加重，ALB 、Ca 出现不同程度的下降。简化‐GFR 和校正‐GFR 与 EPI‐GFR 的相关性均较好（r 分别为0．997和0．995，P ＜0．05）。 EPI‐GFR 比简化‐GFR 平均值高约0．49 mL／（min ×1．73 m2），比校正‐GFR 平均值低约0．81 mL ／（min ×1．73 m2）。结论以 CKD‐EPI 开发方程计算 GFR ，对 CKD 患者肾功能的损伤评价有较好相关性及较好的预测能力，测定简便易行，可弥补其他评估方程导致的过度治疗或降低分级诊断的缺陷，为 CKD分期提供了极大便利，可在临床常规肾功能检测中推广使用。
목적：분석평개미국만성신장병（CKD）류행병합작공작조（CKD‐EPI）개발방정재 CKD 환자병정평고중적작용。방법2012년1월지2014년4월호북성중의원신병문진260례 CKD 환자，용 CKD‐EPI 개발방정계산신소구려과솔（GFR）（EPI‐GFR），동 CKD 환자혈기항（Cr）、뇨산（UA）、청단백（ALB）、개（Ca）、린（P）、광억소 C（CysC）、24 h 뇨단백（UP）、혈홍단백（Hb）등생화지표비교，병여간화신장병음식개량（MDRD）방차계산적 eGFR（간화‐GFR）화중국인교정적 MDRD 방정계산적 eGFR（교정‐GFR）진행비교。결과 EPI‐GFR 여 Cr 、UA 、CysC 、P 급24 h UP 정현저부상관（P ＜0．05），여 Hb 차이유통계학의의（P＜0．05），정현저정상관，수착병정진전，GFR 축점하강，환자빈혈야축점가중，ALB 、Ca 출현불동정도적하강。간화‐GFR 화교정‐GFR 여 EPI‐GFR 적상관성균교호（r 분별위0．997화0．995，P ＜0．05）。 EPI‐GFR 비간화‐GFR 평균치고약0．49 mL／（min ×1．73 m2），비교정‐GFR 평균치저약0．81 mL ／（min ×1．73 m2）。결론이 CKD‐EPI 개발방정계산 GFR ，대 CKD 환자신공능적손상평개유교호상관성급교호적예측능력，측정간편역행，가미보기타평고방정도치적과도치료혹강저분급진단적결함，위 CKD분기제공료겁대편리，가재림상상규신공능검측중추엄사용。
Objective To evaluate the role of equation developed by the chronic kidney disease (CKD) epidemic cooperation working group (CKD‐EPI) in evaluating the status of patients with CKD .Methods A total of 260 outpatients with CKD from Hu‐bei Provincial Hospital of TCM from January 2012 to April 2014 were recruited in this study .Glomerular filtration rate (GFR) was calculated by the equation developed by the CKD‐EPI(EPI‐GFR) ,and compared with serum creatinine (Cr) ,uric acid(UA ) ,albu‐mins (ALB) ,calcium(Ca) ,phosphorus(P) ,cystatin C (CysC) ,24 h urine protein (UP) ,hemoglobin(Hb) and other biochemical in‐dexes ,and also with the estimating GFR calculated by simplified MDRD equation(simplified‐GFR) and Chinese corrected MDRD e‐quation(corrected‐GFR) .Results The EPI‐GFR was negatively correlated with Cr ,UA ,CysC ,P and 24 h UP (P < 0 .05) ,and there was significant difference with Hb (P< 0 .05) which had a significant positive correlation .As the disease progresses ,GFR de‐creased gradually ,anemia was also gradually increase ,ALB ,Ca decreased in varying degrees .There was a good correlation between simplified‐GFR ,correction‐GFR and EPI‐GFR (r was 0 .997 and 0 .995 respectively ,P < 0 .05) .EPI‐GFR was higher than simpli‐fied‐GFR average about 0 .49 mL/(min × 1 .73 m2 ) but lower than correction‐GFR average about 0 .81 mL /(min × 1 .73 m2 ) .Con‐clusion The GFR calculated by CKD‐EPI development equation has good correlation and predictive ability to evaluate the renal function damage in patients with CKD which is easy to determine and also could remedy the defect of excessive treatment and degra‐dation diagnosis with other evaluation equations .It provides a great convenience and could be used widely in clinical routine renal function tests .