【摘要】 目的 評價簡化腎臟病膳食改良試驗(yàn)（MDRDa）方程以及國內(nèi)兩個改良MDRD方程（中國方程1、2）預(yù)測中國慢性腎臟病患者腎小球?yàn)V過率（glomerular filtration rate，GFR）的適用性。 方法 選擇2008年1-12月住院慢性腎病患者250例，用99mTc-DTPA腎動態(tài)顯像法測定GFR（sGFR），同時測定血清肌酐、尿素氮，根據(jù)年齡和性別分別用簡化MDRD方程、中國方程1和中國方程2預(yù)測GFR，即eGFRa （簡化MDRD方程）、eGFR1 （中國方程1）和eGFR2（中國方程2），以sGFR為參考值，將估計(jì)的eGFRs進(jìn)行比較?！〗Y(jié)果 各方程eGFRs與sGFR之間呈顯著相關(guān)關(guān)系。其中中國方程2的估算eGFR2與sGFR具有良好的一致性，總體偏差最小，準(zhǔn)確性最高?！〗Y(jié)論 中國方程2優(yōu)于簡化MDRD方程和中國方程1，可用于中國慢性腎病人群eGFR的計(jì)算。【Abstract】 Objective To evaluate the applicability of three equations for glomerular filtration rate (GFR) in Chinese patients with chronic kidney disease (CKD). Methods A total of 250 patients with CKD which were diagnosed according to K/DAQI guidelines between January and December 2008 were selected. GFR were estimated with Chinese equation 1 (eGFR1), Chinese equation 2 (eGFR2) and abbreviated MDRD (eGFRa) separately, and the results were compared with that of 99mTc-DTPA(sGFR). Results The eGFRs of the three equations were correlated significantly with sGFR. Chinese equation 2 seemed to be the best; eGFR2 showed less bias and higher accuracy than other equations. Conclusion Chinese equation 2 for estimation of GFR may be more accurate in Chinese CKD patients.
【摘要】 目的 以99mTc-DTPA腎動態(tài)顯像法腎小球?yàn)V過率（glomerular filtration rate，GFR）測定為標(biāo)準(zhǔn)，將血清胱抑素C（cystatin C， CysC）檢測與其比較，探討CysC測定在2型糖尿病腎?。╰ype 2 diabetic nephropathy，T2DN）診斷中的意義?！》椒ā?010年6月—2011年1月76例2型糖尿病（type 2 diabetes mellitus，T2DM）患者按24 h尿微量白蛋白（microalbuminuria，m-Alb）分為兩組:正常蛋白尿組（31例）和微量蛋白尿組（45例），同時測定GFR、CysC、血清肌酐（serum creatinine， Scr）和糖化血紅蛋白（hemoglobin A1c， HbA1c），并設(shè)正常自愿者38名作為對照組，進(jìn)行統(tǒng)計(jì)學(xué)分析?！〗Y(jié)果 對照組、T2DM正常蛋白尿組及T2DM微量蛋白尿組CysC水平分別為（1.1±0.6）、（1.6±0.7）、（1.0±0.3） mg/L，各組差異均有統(tǒng)計(jì)學(xué)意義（Plt;0.05）；HbA1c水平分別為（5.4±0.6）%、（7.1±2.7）%、（7.9±3.1）%、兩組T2DM患者與對照組比較，差異均有統(tǒng)計(jì)學(xué)意義（Plt;0.05）；GFR水平分別為（80.9±23.0）、（74.2±26.1）、（79.3±19.7） mL/（min?1.73 m2），各組差異無統(tǒng)計(jì)學(xué)意義（Pgt;0.05）；Scr水平分別為（87.7±23.8）、（93.7±38.4）、（81.5±11.4） μmol/L，組間差異無統(tǒng)計(jì)學(xué)意義（Pgt;0.05）。CysC、Scr和GFR之間呈負(fù)相關(guān)（r=-0.694，-0.692；Plt;0.001）；CysC和Scr之間呈正相關(guān)（r=0.903，Plt;0.001）?！〗Y(jié)論 CysC可作為早期T2DN的檢測指標(biāo)，具有較高的敏感性，但對于輕度到中度GFR降低的診斷準(zhǔn)確性并不優(yōu)于Scr。【Abstract】 Objective To demonstrate the clinical value of serum cystatin-C (CysC) in the assessment of renal function in type-2 diabetic nephropathy (T2DN) by comparing it with the glomerular filtration rate (GFR) measured by 99mTc-DTPA method. Methods From June 2010 to January 2011, 76 patients with type 2 diabetes mellitus (T2DM) were classified into two groups according to their 24 h microalbuminuria (m-Alb) level: the normal albuminuric group (n=31) and the microalbuminuric group (n=45). GFR, Serum creatinine (Scr), CysC, and hemoglobin A1c (HbA1c) were measured. Thirty-eight healthy subjects were recruited as the control group, and statistical analysis was carried out. Results The CysC levels in the control group, the normal albuminuric group and the microalbuminuria group were respectively (1.1±0.6), (1.6±0.7) and (1.0±0.3) mg/L, with a significant difference among the three groups (Plt;0.05). HbA1c level in the three groups were respectively (7.1±2.7)%, (7.9±3.1)% and (5.4±0.6)%, with a significant difference between the two diabetic groups and the control group (Plt;0.05). Scr levels in the three groups were respectively (87.7±23.8), (93.7±38.4), (81.5±11.4) μmol/L; GFR levels in the three groups were respectively (80.9±23.0), (74.2±26.1), (79.3±19.7) mL/(min?1.73 m2); among the three groups the differences of both Scr and GFR were not significant. Both CysC and Scr were negatively correlated with GFR (r=-0.694,-0.692;Plt;0.001), and CysC was positively correlated with Scr (r=0.903, Plt;0.001). Conclusion Increased CysC may be an early indicator of incipient diabetic nephropathy, but the diagnostic accuracy of CysC is not superior to that of Scr in distinguishing between mildly and moderately reduced GFR.