·糖尿病慢性肾脏疾病·

　　肾小球滤过率评估方程对我国糖尿病合并慢性肾脏病患者的应用评价

　　常虹  谈敏  叶山东

　　【 摘要】目的 评价肾小球滤过率( GFR) 评估方程对我国糖尿病合并慢性肾脏病( CKD)患者的适用性。方法 选择294 例糖尿病患者, 用瑞金方程、CG方程、MDRD方程分别预测GFR值,与99mTc-DTPA测的GFR(sGFR)进行比较。结果 Bland- Altman 分析显示瑞金方程估计的GFR 和sGFR 的一致性最好，一致性限度为：-37.2～50.2, 但所有方程估计的GFR 和sGFR 的一致性限度均超过事先规定的专业界值。线性回归结果显示, 瑞金方程估测的GFR 与X 轴的斜率为0.15，与 Y轴的截距为-6.52，均比其他方程更小。瑞金方程估测GFR 15%符合率、30%符合率和50%符合率均较高，且估测GFR 30%符合率高于70%。三种估算公式受血糖的影响较小。结论 瑞金方程可能更适合我国糖尿病合并慢性肾脏病患者评估GFR.

　　【关键词】 糖尿病;肾小球滤过率;慢性肾脏病

Application of modified glomerular filtration rate estimation equations in Chinese diabetic patients with chronic kidney diseases CHANG Hong, TAN Min, YE Shandong. Department of Geriatric Medicine, The Affiliated Provincial Hospital of Anhui Medical University, Hefei 230001, China

　　【Abstract】 Objective To evaluate the applicability of modified formulas based on plasma creatinine levels in Chinese diabetic patients with chronic kidney diseases (CKD). Methods A total of 294 diabetic patients were investigated. Glomerular filtration rate (GFR) was estimated with the Ruijin equation, Cockeroft-Gauh (CG), and Modification of Diet in Renal Disease (MDRD) formula. The accuracy of estimated GFR was compared with 99mTc-DTPA-GFR (sGFR). Results Bland-Altman analysis demonstrated that the Ruijin equation was more consistent with sGFR than the other equations. However, all the equation estimated GFR and sGFR consistency limits exceeded the pre-ordained values. Linear regression analysis showed that in the GFR of Ruijin equation, the slope of X axis was 0.15, and the intercept of Y axis 6.52, both were smaller than in other equations. The 15%, 30%, and 50% accuracies of the Ruijin equation was higher than those of other equations, and the 30% accuracy of Ruijin equation was more than 70%. There was no significant difference between poorly-controlled group and well-controlled group in three equations, which were hardly influenced by blood glucose. Conclusions Ruijin equation is more applicable in Chinese diabetic patients with CKD.

　　【Key words】Diabetes; Glomerular filtration rate (GFR); Chronic kidney diseases (CKD)