数字化智能检测分析系统测定肾小球滤过率的临床研究

摘要

Objective To discuss the clinical application value of determining glomerular filtration rate (GFR)with the new intelligent determination and analysis system for GFR(B&G System).Methods GFR of 216 hospitalized patients suffering from the different diseases was determined accurately by clearance rate of 99mTc-diethylene triamine pentoacetic acid(99mTc-DTPA)(Tc-GFR),and the serum creatinine(SCr)and blood urea nitrogen(BUN)were also determined.At the same time GFR was determined by B&G system and Robert formula(B&G-GFR,Robert-GFR),and creatinine clearance rate(CCr)and GFR were calculated by Cockcroft/Gault formula(CG-CCr-GFR).All the results were compared,and correlation analysis was done for the three groups of data.Results Among 216 patients,B&G-GFR and Tc-GFR in 106 patients with renal insufficiency and 110 patients with normal renal function showed no significant (P<0.05 or P<0.01).The values of B&G-GFR,Robert-GFR,CG-CCr-GFR and Tc-GFR in renal 13.24,32.21±21.8l,all P<0.05).B&G-GFR,Robert-GFR,and CG-CCr-GFR of both groups were positively correlated with Tc-GFR(P<0.05 or P<0.01),but negatively correlated with SCr(P<0.05 or P<0.01).Conclusion B&G-GFR,Robert-GFR and CG-CCr-GFR,to a certain extent,do accuratelyreflect GFR.However,B&G-GFR is more accurate than others,and it can take the place of Tc-GFR clinically.B&G system has the advantage of accuracy,simplicity,speed,safety and low-price compared with other methods for the determination of GFR,and it warrants popularization.%目的 探讨数字化智能检测分析系统(B&G系统)测定肾小球滤过率(GFR)的临床应用价值.方法 采用99锝-二乙烯三胺五乙酸(99mTc-DTPA)清除率准确测定216例不同疾病非透析治疗住院患者的GFR(Tc-GFR),同时检测血清肌酐(SCr)及尿素氮(BUN);并用B&G系统、Robert公式分别测定GFR (B&G-GFR、Robert-GFR),用Cockcroft/Gault公式计算内生肌酐清除率后换算GFR(CG-CCr-GFR),对所得数据进行对比研究及相关分析.结果 216例患者中,肾功能不全组(106例)和肾功能正常组(110例)患者B&G-GFR与Tc-GFR比较差异均无统计学意义(ml·min-1·1.73 m-2:29.13±18.96比32.28±25.03、121.13±49.79比118.48±43.25,均P>0.05),而Robert-GFR(ml·min-1·1.73 m-2:21.45±15.67、93.54±30.01)、CG-CCr-GFR(ml·min-1·1.73 m-2:11.87±8.69、86.27±21.44)均明显低于Tc-GFR (P<0.05或P<0.01).肾功能不全组B&G-GFR、Robert-GFR、CG-CCr-GFR与Tc-GFR差值绝对值(ml·min-1·1.73 m-2:6.15±14.07、13.83±11.36、23.41±24.34)均明显低于肾功能正常组(7.65±6.54、24.94±13.24、32.21±21.81,均P<0.05).两组B&G-GFR、Robert-GFR、CG-CCr-GFR与Tc-GFR 均呈正相关(P<0.05或P<0.01),与SCr均呈负相关(P<0.05或P＜0.01).结论 B&G-GFR、RobertGFR、CG-CCr-GFR均能在一定程度上准确反映GFR,而以B&G-GFR更准确,可代替Tc-GFR应用于临床.B&G系统较其他GFR检测方法具有更准确、简便、快速、安全而廉价的优势,值得临床推广应用.