核素^99mTc—DTPA测定GFR与公式估算GFR的相关性研究

目的：探讨核素^99mTc—DTPA测定GFR与MDRD公式、简化MDRD公式估算GFR的相关性。方法：178例CKD患者，用核素^99mTc—DTPA测定GFR，同时测定血清肌酐、尿素氮和白蛋白，根据年龄和性别分别用MDRD和简化MDRD公式估算GFR。结果：核素^99mTc—DTPA测定的GFR与MDRD公式估算的GFR有显著性差异，P=0．0001，MDRD公式高估了GFR；核素^99mTc—DTPA测定的GFR与简化MDRD公式估算的GFR亦有显著性差异，P=0．0001，简化MDRD公式低估了GFR；MDRD公式估算的GFR与核素^99mTc—DTPA测定的GFR呈正相关，r=0．8292，P〈0．01；简化MDRD公式估算的GFR与核素^99mTc—DTPA测定的GFR值呈正相关，r=0．8277，P〈0．01。结论：MDRD公式、简化MDRD公式估算的GFR与核素^99mTc—DTPA测得的GFR有差异，需进一步校正后用于估算GFR。

Comparison of the Glomerular Filtration Rate Estimated by Equation with That Assayed with Isotope 99m Tc-DTPA Clearance

Objective To investigate the differences among the glomerular filtration rates (GFR) estimated by MDRD equation (MDRD-GFR), estimated by simplified MDRD equation (MDRDs-GFR) and assayed with isotope 99mTc-DTPA clearance (99mTc-GFR). Methods GFR was assayed with isotope 99mTc-DTPA clearance in 178 patients with chronic kidney disease. GFRs were also calculated with both MDRD and modified MDRD equations. Serum creatinine, urea nitrogen and albumin were measured in all patients. Results There were significant differences between 99mTc -GFR and MDRD-GFR, with MDRD overestimation (P<0.01). There were also significant difference between 99mTc-GFR and modified MDRDs-GFR, with modified MDRD underestimation (P<0.01). Both the GFRs obtained from the two equations were positively correlated with the GFR obtained with isotope assay (P<0.01). Conclusion There were significant differences among the 99mTc-GFR, MDRD-GFR and modified MDRDs-GFR. Adequancy of the present two equations seems to be questionable. More attention should be paid to set up an accurate equation to estimate GFR.