Cystatin C相关方程在计算慢性肾脏病肾小球滤过率的对照研究

目的 评价血清半胱氨酸蛋白酶抑制剂C（Cystatin C，CysC）相关方程在不同病因引起慢性肾脏病（CKD）患者的肾小球滤过率（GFR）计算中的临床应用价值。方法选择CKD患者255例，运用MDRD方程（mGFR）、MDRD简化方程（rnGFR）、Hoek方程（hGFR）、2006年中华医学会肾脏病学分会推荐的方程（c-cGFR1，c-cGFR2）计算GFR，与^99m-二乙撑三胺五乙酸（^99m TcDT-PA）肾动态显像测得的。肾小球滤过率（sGFR）进行比较。结果在分期比较中，各方程估算的GFR和sGFR相关性一般，CysC相关方程能更敏感反应GFR；在不同病因分组中，各方程估算的GFR和sGFR均明显相关，特别是c-cGFR2。结论在CysC相关方程中，以2006中华公式2计算的c-cG-FR2与sGFR相关性及一致性最好，并且在糖尿病肾脏病组中，各方程相关系数优于其他组别，有必要进一步大规模临床研究证明其应用价值。

A controlled study of Cystatin-C dependent equations for patients with chronic kidney disease

Objective To evaluate the applied value of the serum Cystatin-C （Cys C） dependent equations for calculating the glomerular filtration rate （GFR） in patients with chronic kidney diseases （CKD） caused by various pathogenic factors. Methods 255 patients with CKD were selected. The GFR was calculated by using MDRD equation, simplified MDRD equation, Hoek equation and the equa- tions （c cGFR1, c-cGFR2） recommended by Chinese Medical Association Section of Nephrology in 2006, and compared with sGFR measured by 99mTc-DTPA renal dynamic imaging. Results In the comparison grouped by stage, the GFR from each equation had general correlation with sGFR, while Cystatin-C dependent equations were more sensitive for GFR;in the comparison grouped by pathogenic factors,GFR from each equation was obviously correlated with sGFR, especially for c-cGFR2. Conclu- sions In all Cys C dependent equations,c-cGFR2 has the best correlation and consistency with sGFR. Each equation has better correlations coefficients in diabetic nephropathy group than in the others, which demands an advanced larger scale clinical research to prove their applied value.