不同肾小球滤过率估算方程在术前肾癌患者中的临床应用研究

发布时间：2018-01-27 04:25

本文关键词： 肾肿瘤肾小球滤过率肾功能诊断性能　出处：《重庆医学》2017年08期 　论文类型：期刊论文

【摘要】：目的评价7种不同估算肾小球滤过率(eGFR)方程在术前肾癌患者肾功能监测方面的应用价值。方法选取2012年1月至2015年9月该院泌尿外科肾细胞癌术前住院患者386例,以99mTc-DTPA肾动态显像测定肾小球滤过率(GFR)作为参考标准(rGFR),与7种eGFR做比较。用Spearman相关性分析和Bland-Altman一致性分析评价"金标准"GFR(rGFR)与eGFR的相关性;计算系列诊断性能指标及受试者工作特征曲线(ROC)评价各估算方程在不同影响因素下的诊断能力。结果 7种eGFR与rGFR的结果具有相关性(P均0.001)。从诊断性能来看,eGFR1和eGFR2较好;而通过各估算方程ROC曲线发现,eGFR5、eGFR2和eGFR1的ROC曲线下面积相对较高。结论 7种eGFR方程在术前肾癌患者肾功能评价方面存在一定差异。CKD-EPI公式诊断价值最大,其次为瑞金公式,但是对于大于70岁的患者不适用。
[Abstract]:Objective to evaluate seven different estimates of glomerular filtration rate (GFR). Methods from January 2012 to September 2015, 386 patients with renal cell carcinoma were selected. The glomerular filtration rate (GFR) was measured with 99mTc-DTPA renal dynamic imaging as the reference standard. Spearman correlation analysis and Bland-Altman consistency analysis were used to evaluate the correlation between GFRrGFR and eGFR. A series of diagnostic performance indexes and the operating characteristic curve of the subjects were calculated to evaluate the diagnostic ability of each estimation equation under different influence factors. Results the results of 7 eGFR and rGFR were correlated (. P all 0.001g. From the diagnostic performance point of view. EGFR1 and eGFR2 were better. The eGFR5 was found by the ROC curves of each estimation equation. The area under ROC curve of eGFR2 and eGFR1 is relatively high. Conclusion. There were some differences among the seven eGFR equations in the evaluation of renal function in patients with renal cell carcinoma before operation. The CKD-EPI formula had the greatest diagnostic value. The next is the Ruijin formula, but not for patients over 70 years of age.
【作者单位】：重庆医科大学附属第一医院输血科;重庆医科大学附属第一医院医学检验科;
【分类号】：R737.11
【正文快照】： 肾小球滤过率(glomerular filtration rate,GFR)是评估肾功能的一个重要指标,但是其参考方法费用昂贵,临床依从性差,难以作为临床常规检测手段。2012年,改善全球肾脏病预后组织(KDIGO)颁布的“慢性肾脏病评估与管理临床实践指南”推荐联合血清肌酐(Cr)及其估算的GFR值(eGFR)进

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