应用MDRD公式与简化MDRD公式估测心力衰竭患者的肾小球滤过率水平

目的 探讨心力衰竭(HF)患者肾小球滤过率水平(GFR)和心功能分级的关系.方法 647例HF患者,分为急性左心衰患者和慢性心力衰竭(CHF)患者,后者按NYHA心功能分级分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级,5组患者分别为18、31、200、253、145例;选取无心力衰竭的患者54例作为对照组.所有入选者抽血检查肝肾功能等项目,并根据肾脏病膳食改良试验(MDRD)公式及简化MDRD公式分别计算肾小球滤过率(eGFR).结果 2个公式所得出的eGFR水平在对照组、心功能Ⅱ级组、心功能Ⅰ级组、心功能Ⅲ级组、心功能Ⅳ级组、急性左心衰组中均逐渐降低.结论 肾小球滤过率水平与心力衰竭程度呈负相关,心力衰竭程度越重,肾小球滤过率水平越低.

Estimation of glomerular filtration rate using MDRD formula and simplified MDRD formula in heart failure patients

Objective To evaluate the relationship between glomerular filtration rate and heart function in heart failure patients. Methods 647 patients with heart failure were divided into 2 groups,acute heart failure group (18 patients) and chronic heart failure group (629 patients),and 629 CHF patients were subdivided into 4 subgroups according to the New York Heart Association (NYHA) criteria. The numbers of patients in group NYHAⅠ,Ⅱ,Ⅲ and Ⅳ were 31,200,253 and 145,respectively. 54 patients without heart failure were recruited in the control group. Liver and renal functions were tested for calculation of glomerular filtration rate using Modification of Diet in Renal Disease (MDRD) and simplified MDRD (sMDRD) equations. Results The glomerular filtration rates calculated using Modification of Diet in Renal Disease (MDRD) and simplified MDRD (sMDRD) equations decreased gradually in control group,NYHA Ⅱ group,NYHA Ⅰ group,NYHA Ⅲ group,NYHA Ⅳ group and acute heart failure group. Conclusion There is negative correlation between glomerular filtration rate and heart function. The eGFR decreases with more severe heart failure.