采样时间对碘海醇清除率测定肾小球滤过率的影响研究

摘要

目的 比较不同采样时间对碘海醇清除率测定肾小球滤过率(GFR)的影响,确定双血浆法准确性较好的采血时间点.方法 入选北京大学人民医院自2015年10月至2016年9月收治的肾脏病患者78例,同时选取40名健康志愿者作为对照组.所有受试者单次注射碘海醇5 mL后于2h、3h、4h静脉采血,采用高效液相色谱法检测血浆碘海醇浓度并计算GFR.以多点采血结果MPSM-GFR为参考标准,比较双血浆法DPSM-GFR与其相关性和一致性.结果 双血浆法GFR23、GFR34、GFR24与MPSM-GFR的相关系数R分别为0.990、0.971、0.999,平均偏差为(-0.95±4.76)mL/(min·1.73m2)、(0.39±8.94)mL/(min·1.73m2)、(-0.59±1.65)mL/(min·1.73m2),位于MPSM-GFR±5％范围内值的个数和比例分别为86(72.88％)、72(61.02％)、117(99.15％).结论 双血浆法GFR24与MPSM-GFR一致性最好,在2h、4h两个时间点采血可代替三点采血结果以减少采血次数.%Objective Compare the effect of different sampling time on dual-plasma-sample method in determination of iohexol clearance to find the optimal sampling time of DPSM.Methods 40 healthy volunteers and 78 patients with kidney disease were enrolled,blood samples were drawn after a single-injection of5mL iohexol at 2 h,3 h and 4 h.Iohexol concentration was detected by HPLC to calculate GFR.The agreement and accuracy between DPSM-GFRs and MPSM-GFR were compared.Results The agreement between GFR23,GFR34,GFR24 and MPSM-GFR were 0.990,0.971,0.999 respectively,mean difference were (-0.95±4.76)mL/(min·1.73m2),(0.39±8.94)mL/(min·1.73m2),(-0.59±1.65)mL/(min·1.73m2) respectively.Correlation The sampling time of DPSM at 2 h and 4 h showed the best agreement and accuracy with MPSM-GFR.