Cockcroft-Gault公式和改良MDRD公式估算糖尿病患者肾功能准确性的比较

摘要

Objective To evaluate the accuracy of Cockcroft-Gauh(C-G) and modified MDRD equations in estimating the glomerular filtration rate (GFR) in Chinese patients with diabetes.Methods GFR measured by dynamic renal imaging with radio- labeled diethylenetriaminepentaacetie acid (99mTc-DTPA) was used as the reference standard.Serum creatinine measured by means of alkaline picrate and body weight were used to calculate GFR by C-G eqution and modified MDRD equation respectively, and results were compared with measured GFR.The agreements between measured and calculated GFR were evaluated by Kappa statistics,the precision was assessed by R2 from linear regression and the accuracy was assessed by P30.Results The measured GFR was (48±18) ml/(min · 1.73 m2) in 52 patients with diabetes.The calculated GFR was (42±10) ml/(min · 1.73 m2) from C-G equation,and (51±18) ml/(min · 1.73 m2) from modified MDRD equation.Spearman correlation analysis showed good cor- relation between measured GFR and calculated GFR.Both of thcm correlated significantly withage, height, body weight and serum ereatinine (P < 0.01).For C-G equation,the Kappa was 0.2880,the R2 was 0.4922.and the P30 was 57.7%.For modified MDRD equation,the Kappa was 0.3805,the R2 was 0.5763 and the P30 was 73.1%.Conclusion Compared with the reference standard, modified MDRD equation showed better accuracy than C -G Equation in Chinese patients with diabetes.%目的 评估美国肾脏病基金会推荐的Cockeroft-Gault(C-G)公式和改良MDRD公式对中国糖尿病患者肾功能估算的准确性.方法 以99mTc-DTPA肾动态显像测定的肾小球滤过率(GFR)为参考标准,分别用C-G公式和改良MDRD公式计算GFR,结果与同位素法测定值进行比较,评估计算公式的准确性,并检验其一致性.结果 52例糖尿病患者同位素法测定GFR为(48±18)ml/(min·1.73 m2),C-G公式计算值为(42±10)ml/(min·1.73 m2),改良MDRD公式计算值为(51±18)ml/(min·1.73 m2).相关分析表明,测得GFR值、计算GFR值与年龄、血肌酐、身高及体重均显著相关(P<0.01),一致性检验表明,C-G公式的Kappa值为0.2880,R2为0.4922,P30为57.7%,改良MDRD公式的Kappa值为0.3805,R2为0.5763,P30为73.1%.结论 以同位素法测得GFR值为标准,对于中国糖尿病患者肾功能的估算,改良MDRD公式的准确性优于C-G公式.