摘要
目的探讨4种估算肾小球滤过率(eGFR)计算公式[MDRD中国修正公式(MDRDCN),基于胱抑素C(CysC)的CKD-EPI公式(CKD-EPICysC),2009年开发的基于血肌酐(Scr)的CKD-EPI公式(CKD-EPI2009Scr),2012年开发的基于Scr与CysC的CKD-EPI公式(CKD-EPI2012Scr-CysC)]对肾功能的评估结果。方法收集6422例住院患者的性别、年龄、Scr、CysC水平等基线资料,分别用上述4种公式计算eGFR,比较4种公式计算结果间的差异。结果4种公式的eGFR计算结果从高到低依次为MDRDCN[(94.00±50.12)mL/(min·1.73 m2)]、CKD-EPI2009Scr[(88.27±36.88)mL/(min·1.73 m2)]、CKD-EPI2012Scr-CysC[(63.95±27.94)mL/(min·1.73 m2)]、CKD-EPICysC[(48.64±22.90)mL/(min·1.73 m2)],各结果间比较,差异均有统计学意义(P<0.05)。在慢性肾脏病(CKD)患者中,4种公式的eGFR计算结果比较,差异均无统计学意义(P>0.05);在非CKD患者中,4种公式的eGFR计算结果比较,差异均有统计学意义(P<0.05)。男性与女性患者4种公式的eGFR计算结果比较,差异均有统计学意义(P<0.05);男性与女性患者4种公式的eGFR计算结果分布情况大致相同。当4种公式计算的eGFR≥90 mL/(min·1.73 m2)时,MDRDCN与CKD-EPI2009Scr对应的Scr及CysC水平均高于CKD-EPICysC与CKD-EPI2012Scr-CysC对应的Scr及CysC水平,差异有统计学意义(P<0.05)。结论MDRDCN、CKD-EPI2009Scr、CKD-EPI2012Scr-CysC及CKD-EPICysC的eGFR计算结果存在差异,其中MDRDCN、CKD-EPI2009Scr可能会高估患者的肾功能,而CKD-EPI2012Scr-CysC、CKD-EPICysC更能准确反映患者肾损伤情况。
Objective To explore the evaluation results of renal function by 4 calculation formulas[MDRD China revise formula(MDRDCN),CKD-EPI formula base on cystatin C(CysC),(CKD-EPICysC),CKD-EPI formula base on blood creatinine(Scr)develop in 2009(CKD-EPI2009Scr),CKD-EPI formula base on Scr and CysC develop in 2012(CKD-EPI2012Scr-CysC)]for estimating glomerular filtration rate(eGFR).Methods The baseline data of gender,age,Scr and CysC levels of 6422 inpatients were collected,eGFR was calculated by the above 4 formulas,and the differences between the calculation results of the 4 formulas were compared.Results The eGFR calculation results of the 4 formulas from high to low were MDRDCN[(94.0±50.12)mL/(min·1.73 m2)],CKD-EPI2009Scr[(88.27±36.88)mL/(min·1.73 m2)],CKD-EPI2012Scr-CysC[(63.95±27.94)mL/(min·1.73 m2)],CKD-EPICysC[(48.64±22.90)mL/(min·1.73 m2)],there were significant differences among each result(P<0.05).In patients with chronic kidney disease(CKD),there was no statistically significant difference in the eGFR calculation results of the 4 formulas(P>0.05).In non-CKD patients,the differences in the eGFR calculation results of the 4 formulas were statistically significant(P<0.05).There were significant differences in eGFR calculation results of the 4 formulas between male and female patients(P<0.05).The distribution of eGFR calculation results of the 4 formulas for male and female patients was roughly the same.When the eGFR calculated by the 4 formulas was≥90 mL/(min·1.73 m2),the Scr and CysC levels corresponding to MDRDCN and CKD-EPI2009Scr were higher than those corresponding to CKD-EPICysC and CKD-EPI2012Scr-CysC,the differences were statistical significance(P<0.05).Conclusion MDRDCN,CKD-EPI2009Scr,CKD-EPI2012Scr-CysC and CKD-EPICysC have different calculation results for eGFR,among them,MDRDCN and CKD-EPI2009Scr might overestimate the renal function of patients,while CKD-EPI2012Scr-CysC and CKD-EPICysC could more accurately reflect renal injury.
作者
张新鹏
吴丽娜
ZHANG Xinpeng;WU Lina(Department of Clinical Laboratory,Shengjing Hospital of China Medical University,Shenyang,Liaoning 110000,China)
出处
《国际检验医学杂志》
CAS
2020年第18期2214-2218,共5页
International Journal of Laboratory Medicine
基金
辽宁省自然科学基金项目(2019-ZD-0764)。
关键词
肾小球滤过率
估算肾小球滤过率
肾功能
计算公式
glomerular filtration rate
estimated glomerular filtration rate
renal function
calculation formula
