摘要
目的评估美国肾脏病基金会推荐的Cockcroh—Gault（C-G）公式与简化MDRD公式对中国老年男性肾功能估算的准确性。方法以^99mTc-DTPA同位素测定的肾小球滤过率（GFR）为参考标准，分别用C-G公式和简化MDRD公式估算GFR（eGFR），与同位素测定结果进行比较，并进行一致性检验，评价估算公式的准确性。结果（1）171例老年男性，年龄（77．4±9．6）岁，体重（74．2±9．7）kg，体重指数（25．7±2．9）kg／m^2，血肌酐（134．11±46．72）μmol／L；（2）同位素测定GFR为（40．19±16．00）ml·min^-1·1．73m^-2，C-G公式为（43．54±14．64）ml·min^-1·1．73m^-2，简化MDRD公式为（52．90±15．50）ml·min^-1·1．73m^-2；（3）C—G公式估算值与GFR的差值中位数为4．17ml·min^-1·1．73m^-2简化MDRD公式估算值与GFR的差值中位数为13．60ml·min^-1·1．73m^-2；（4）相关分析表明，GFR、估算GFR值与年龄、血肌酐、身高、体重均有相关性（P＜0．01）；（5）一致性检验分析表明，C-G公式Kappa值为0．348，R^2为0．535，P30为65．5％，简化MDRD公式的Kappa值为0．131，R^2为0．448，P30为42．7％。结论与参考标准比较，两个估算公式对于老年男性肾功能的估算结果均不理想，相比之下，C-G公式的准确性优于简化MDRD公式。对于老年人群肾功能的估算公式，尚需要进一步研究。
Objective To evaluate the accuracy of Cockcroft-Gault （C-G） and simplified MDRD equations in estimating the glomerular filtration rates （GFR） in Chinese elderly male patients. Methods GFR measured by radiolabeled diethylenetriaminepentaacetic acid （^99mTc-DTPA） was used as the reference standard. Serum creatinine measured by means of alkaline picrate and body weight were used to estimate GFR （eGFR） by C-G equation and simplified MDRD equation respectively. eGFRs were compared with measured GFR. The agreements between them were evaluated by kappa statistics. The precision was evaluated by R^2 from linear regression. The accuracy was measured by the percentage of GFR estimates within 30% of the measured GFR （P30）. Results One hundred and seventy one elderly male patients aged （77.4 ± 9.6）years （60-96 years） were enrolled in this study. The body weight was （ 74. 2±9.7） kg and the serum creatinine was （ 134.11±46.72）μmol/L. The measured GFR was（40.19±16.00）ml·min^-1·1.73 m^-2. The eGFR from C-G equation （eGFR1） was（43.54±14.64） ml · min^-1 · 1.73 m^-2. eGFR from simplified MDRD equation （eGFR2） was （52.90±15.50）ml · min^-1· 1.73 m^-2. The median bias was 4.17 ml · min^-1 · 1.73 m^- 2 （p〈 0.001） between eGFR1 and measured GFR, and was 13.60 ml · min^-1 · 1.73 m^-2 （P〈0. 001） between eGFR2 and measured GFR. Spearman correlation analysis showed good correlation between measured GFR and eGFRs. Both of them correlated well with age, height, body weight and serum creatinine （P〈0. 001）. For C-G equation the Kappa value was 0. 348, and the R^2 was 0. 535, P30 was 65.5%. For simplified MDRD equation the Kappa value was 0. 131, and the R2 was 0. 535, P30 was 42.7%. Conclusions Compared with the reference standard, both equations show a lower degree of accuracy. The C-G equation shows a little better than simplified MDRD equation in Chinese elderly male patients. More attention should be paid to set up an accurate GFR-estimating equation on the elderly patients.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2007年第2期97-100,共4页
Chinese Journal of Geriatrics
基金
本文得到了成龙杨寿成公益慈善基金会的资助,特此志谢
