基于血清肌酐的肾小球滤过率估算值与99mTc-肾小球滤过率的相关性9

目的 分析肾小球滤过率（GFR）公式估算值(eGFR)与99锝－二乙烯三胺五醋酸 (99mTc-DTPA)法测定值（99mTcGFR）的相关性，探讨适合中国慢性肾脏病（CKD）住院患者eGFR的估算方法。方法 选择1 033例慢性肾脏病住院患者作为研究对象，99mTc-DTPA肾动态显像法测定 99mTc-GFR，酶法检测血清肌酐（SCr）水平。采用Cockcroft-Gault公式、肾脏病膳食改良试验（MDRD）公式、简化MDRD公式、中国MDRD公式、中国简化MDRD公式及CKD-EPI公式计算并用体表面积（BSA）校正后得到eGFR，分别以C-G GFR、7GFR、aGFR、c-7GFR4、c-aGFR4和CKD-EPI-GFR表示。分析99mTc-GFR与eGFR的相关性。结果 相关回归分析显示，C-G GFR、7GFR、aGFR、c-7GFR4、c-aGFR4和CKD-EPI-GFR与99mTc-GFR的相关系数（r）分别为0.805、0.797、0.783、0.791、0.777和0.800，与99mTc-GFR偏差值均值分别为－2.46、－14.24、－16.53、－20.92、－22.92和－13.56。患者99mTc-GFR与SCr水平呈近似双曲线的关系。结论 在基于SCr的公式估算得到的eGFR中，C-G GFR与99mTc-GFR的相关程度最高。提示当以酶法SCr测定结果作为数据源时，C-G公式较适合中国CKD住院患者eGFR的估算。

Relationship between estimated glomerular filtration rate from serum creatinine and 99mTc-glomerular filtration rate

Objective To analyse the relationship between estimated glomerular filtration rate (eGFR) and 99mTc-glomerular filtration rate (99mTc-GFR), and explore the suitable methods for eGFR of Chinese inpatients with chronic kidney disease (CKD). Methods One thousand and thirty-three inpatients with CKD were selected, 99mTc-GFR was measured by 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) dynamic renal imaging, and serum creatinine (SCr) was determined by enzymatic method. Cockcroft-Gault formula, modification of diet in renal disease (MDRD) equation, abbreviated MDRD equation, MDRD equation for Chinese, abbreviated MDRD equation for Chinese and CKD-EPI equation were employed for calculation and body surface area (BSA) was used for correction of eGFR (C-G GFR, 7GFR, aGFR, c-7GFR4, c-aGFR4 and CKD-EPI-GFR, respectively). The relationship between 99mTc-GFR and eGFR was analysed. Results Correlation regression analysis revealed that the correlation coefficients between C-G GFR, 7GFR, aGFR, c-7GFR4, c-aGFR4, CKD-EPI-GFR and 99mTc-GFR were 0.805, 0.797, 0.783, 0.791, 0.777 and 0.800, respectively, and the differences were -2.46, -14.24, -16.53, -20.92, -22.92 and -13.56, respectively. There was approximate hyperbolic relation between 99mTc-GFR and SCr. Conclusion C-G GFR is most closely related to 99mTc-GFR among eGFR from SCr, C-G formula may be a suitable method for eGFR of Chinese inpatients with CKD when SCr is measured by enzymatic method.