MDRD公式及简化MDRD公式估测心力衰竭患者的肾小球滤过率（eGFR）水平的研究

目的：探讨心力衰竭（HF）患者肾小球滤过率水平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组病人分别为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。

Glomerular filtration rate estimated by MDRD formula and simplified MDRD formula in heart failure patients

Objective: To evaluate the relationship of glomerular filtration rate and heart function in heart failure patients. Method: 647 patients with heart failure were divided into 2 groups, acute heart failure group(18 patients) and chronic heart failure group(629 patients), 629 CHF patients were divided into 4 groups according to the New York Heart Association (NYHA) criteria, The number of NYHAⅠ-Ⅳwas 236 ,138 ,132 ,59 respectively, 54 patients who didnot have heart failure were involved as control group. All of patients tested the liver and renal function,and calculated the glomerular filtration rate by Modification of Diet in Renal Disease (MDRD) and simplified MDRD (sMDRD) equations. Result: The glomerular filtration rate calculated by Modification of Diet in Renal Disease (MDRD) and simplified MDRD (sMDRD) equations decreased in control group, NYHA Ⅱ group, NYHA Ⅰ group, NYHA Ⅲ group, NYHA Ⅳ group and acute heart failure group gradually Conclusion: The glomerular filtration rate level and the heart function are related negatively, The eGFR level get lower in patients with severe heart failure.