·糖尿病性肾脏疾病·

　　张萌 黄清梅 简小金 方红娟 杨金奎

　　作者单位：338025，江西省新余市人民医院内分泌科(张萌、黄清梅、简小金);中华医院管理杂志编辑部(方红娟);首都医科大学附属同仁医院内分泌科(杨金奎)

　　通讯作者：杨金奎

　　【摘要】 目的 探讨不同血糖水平对2型糖尿病患者肾小球滤过率(GFR)及其评估方程的影响 方法 选择经同位素99mTc-DTPA测定GFR的2型糖尿病患者495例，HbA1c与99mTc-DTPA测定GFR及CG方程、MDRD方程和MCQ方程GFR估计值之间进行相关性分析;以HbA1c=8%为临界值，比较两组间各评估方程的精确性和准确性。 结果 经同位素测定的GFR为(70.11±20.54) ml·min-1·(1.73 m2)-1,HbA1c与同位素测定GFR及CG方程、MDRD方程和MCQ方程GFR估计值呈正相关(r值分别为0.196、0.201、0.289和0.181，P<0.01)。无论血糖水平如何，CG方程的准确性都明显高于其他两个方程。 结论 近期高血糖增加同位素测定GFR和方程估算GFR的水平。虽然这些评估方程存在一些不足之处，但由于目前尚缺乏专门针对糖尿病人群的评估方程，在临床实际工作中采用CG方程来评估2型糖尿病患者的GFR不失为一个简便实用的方法。

　　【关键词】糖尿病，2型;肾小球滤过率;CG方程;MDRD方程;MCQ方程

　　doi:10.3969/j.issn.1006-6187.2011.08.007

　　The influence of blood glucose level on glomerular filtration rate and its estimation equations in type 2 diabetes

　　ZHANG Meng, HUANG Qing-mei, JIAN Xiao-jin, et al. Department of Endocrinology, People’s Hospital of Xinyu city, Jiangxi Xinyu 338025,China

　　Correspording author:YANG Jin-kui

　　【Abstract】 Objective To discuss the influence of different blood glucose levels on glomerular filtration rate (GFR) and on its estimation equations in type 2 diabetes. Methods 495 type 2 diabetic patients undergoing GFR measurement using 99mTc-DTPA were enrolled in this study. The correlations were performed between glycosylated hemoglobin (HbA1c) and 99mTc-DTPA measured GFR and its estimations by CG, MDRD and MCQ equations. The precision and accuracy were compared among these three estimating equations under the threshold of HbA1c 8%. Results When GFR measured using 99mTc-DTPA was (70.11±20.54) ml·min-1· (1.73 m2)-1,HbA1c was positively correlated with isotopically measured GFR and its estimations by CG, MDRD and MCQ equations (r=0.196, 0.201, 0.289 and 0.181, P<0.01). CG equation was more accurate than the other equations regardless of blood glucose level. Conclusions Acute hyperglycemia increases isotopically measured GFR and its estimations. These equations all have some disadvantages in estimating GFR, but in clinical work it is more convenient and practical to use CG equation to estimate GFR in Chinese type 2 diabetes.

　　【Key words】Diabetes mellitus,type 2; Glomerular filtration rate; CG equation; MDRD equation; MCQ equation