不同方法对肾功能评估的价值

目的探讨临床上常用的几种肾功能评估方法的相对准确性，寻求更为简便、快捷的肾功能评估方法。方法选择慢性肾脏病（CKD）患者80例，分别用^99mTc-DTPA肾动态显像法测定肾小球滤过率（GFR），同时检测患者血肌酐（SCr）、血清胱抑素C（CysC）浓度，根据SCr分别用Cock-croft-Gault（C-G）方程和简化MDRD方程估算肾小球滤过率（分别为eGFR1、eGFR2）。按GFR值将患者分为4组，即A组：CKD1期；B组：CKD2期；C组：CKD3期；D组：CKD4期；排除CKD5期的患者。观察所有和各组患者eGFR1、eGFR2、SCr、CysC与GFR的相关性。结果总样本中，eGFR1、eGFR2与GFR呈正相关，SCr、CysC与GFR呈负相关（P〈0．01）。在各组中，A组：eGFR1、eGFR2、SCr与GFR之间均无明显相关性（P〉0．05）；而B、C、D组中eGFR1、eGFR2与GFR呈正相关（P〈0．01），SCr与GFR呈负相关（P〈0．05）；CysC在A、B、C、D各组中均与GFR呈负相关（P〈0．01）。结论CKD2、3、4期患者eGFR1、eGFR2、SCr与GFR均有一定的相关性，但不论何期CKD患者，CysC均能准确反映其肾功能状况，且更加简便、快捷。

Study on accuracy of different methods in estimating renal function

Objective To evaluate the accuracy of several methods in estimating renal function in order to find a kind of brief and rapid method. Methods Glomerular filtration rate （GFR） in 80 patients was tested by ^99mTc-DTPA renography （Gates method） （GFR）, and the serum creatinine （SCr） and cystatin C （Cys C） were determined. The estimated GFR （eGFR） was calculated by Cockcroft-Gault formula （eGFR1） and simplified MDRD equation （eGFR2）. The patients were divided into 4 groups according to GFR. Group A： stage 1;Group B： stage 2; Group C： stage 3; Group D： stage 4. The patients in stage 5 were excluded. The relationship between GFR with eGFR1, eGFR2, SCr and Cys C was analyzed in all patients and in different groups. Results In all patients,the GFR had a positive relationship with eGFR1 and eGFR2, and had a negative relationship with SCr and Cys C （all P〈0. 01 ）. In group A, there was no relationship between GFR with eGFR1, eGRF2 and SCr. The relationship between GFR with eGFR1 and eGFR2 was positive （all P〈0. 01）, and with SCr was negative （P〈0. 05） in groups B, C, and D. But the relationship between GFR and Cys C was negative in groups A, B, C, and D （all P〈0. 01 ）. Conclusion The GFR was closely related to eGFR1, eGFR2 and SCr in stages2,3, and 4. Cys C could be used as a brief and rapid reflection of the renal function in each stage.