血肌酐、胱抑素C、简化MDRD和LeBricon公式在评估肾移植术后肾功能中的作用

摘要

目的：探讨血肌酐（Scr），胱抑素C（Cys C），简化MDRD和Le Bricon公式在评估患者肾移植术后肾功能中的诊断价值。方法收集2012年9月～2014年6月间57例肾移植患者和48例健康对照组采用99m Tc-DTPA肾动态显像法（RDI）测定肾小球滤过率（GFR），检测 Scr和Cys C，利用简化 MDRD和 Le Bricon 公式计算 GFR估算值，进行 spearman相关性分析，并用受试者工作特征曲线（ROC）评价诊断价值。结果肾移植组 DTPA，Scr，Cys C，简化 MDRD和 Le Bri-con估算值分别为60.69±13.52 ml/min/1.73m2，1.34±0.28 mg/dl，1.42±0.15 mg/dl，66.97±15.85 ml/min/1.73m2和59.93±10.23 ml/min/1.73m2；对照组值分别为90.12±12.61 ml/min/1.73m2，0.97±0.09 mg/dl，0.86±0.12 mg/dl，87.13±18.29 ml/min/1.73m2和94.80±18.73 ml/min/1.73m2，组间比较均有统计学意义（t＝1.01～6.12，P 值均＜0.01），Scr，Cys C，简化 MDRD和 Le Bricon估算值与DTPA之间具有不同的相关性（r＝-0.76～0.82，P 值均＜0.01）， ROC曲线下面积分别为0.856，0.973，0.814和0.971。结论 Scr，Cys C，MDRD和 Le Bricon均对肾移植后受体患者慢性肾病有一定的预测价值，但 Cys C及基于 Cys C的 Le Bricon评估方程分别优于肌酐及基于肌酐的简化 MDRD评估方程。%Objective To investigate diagnostic value of the serum creatinine (Scr),Cystatin C (Cys C),MDRD and Le Bricon formula in the renal function after renal transplantation.Methods The total renal glomerular filtration rate (GFR)of 5 7 ca-ses of renal transplantation patients and 48 healthy control group were determined using 99mTc-DTPA from 2012 September to 2014 June.Scr,Cys C and calculate the estimated glomerular filtration rate of MDRD and Le Bricon,correlation analysis by Spearman,and use receiver operating characteristic curve (ROC)to evaluate the diagnosis value.Results DTPA,Scr, Cys C,MDRD and Le Bricon intransplantation group was 60.69±13.52 ml/min/1.73m2,1.34±0.28 mg/dl,1.42±0.15 mg/dl,66.97±15.85 ml/min/1.73m2 and 59.93±10.23 ml/min/1.73 m2 ,respectively.Control group were 90.12±12.61 ml/min/1.73m2 ,0.97±0.09 mg/dl,0.86±0.2 mg/dl,87.13±18.29 ml/min/1.73m2 and 94.80±18.73 ml/min/1.73m2 , respectively.There were statistically significant (t=0.237~1.35,P< 0.01)among groups.Scr,Cys C,MDRD and Le Bri-con between DTPA were different correlation (r=-0.76~0.82,P<0.01).The area under ROC curve were 0.856,0.973, 0.814 and 0.971,respectively.Conclusion Scr,Cys C,MDRD,Le Bricon have some predictive value to chronic kidney dis-ease in all patients after renal transplant recipients,but Cys C and Le Bricon were superior to the Scr and MDRD equation.