基于肌酐与胱抑素的CKD-EPI新方程对我国慢性肾脏病患者适用性的对比研究

发布时间：2018-08-02 18:19

【摘要】：目的:评价美国慢性肾脏病流行病学协作组(CKD-EPI)2012年报道的基于肌酐和胱抑素C的肾小球滤过率(GFR)联合预测方程(CKD-EPI2012SCr-SCys C)是否比2009年报道的联合预测方程(CKD-EPI2009SCr-SCys C)、中国e GFR课题组马迎春等2007年报道的联合预测方程(Ma1和Ma2)更适于我国慢性肾脏病(CKD)患者GFR的预测。方法 :收集669例CKD患者资料,以99m Tc-DTPA肾动态显像法测定的GFR作为参考GFR(r GFR),用CKD-EPI2012SCr-SCys C、CKD-EPI2009SCr-SCys C、Ma1和Ma2估算GFR(分别记为e GFR1、e GFR2、e GFR3和e GFR4),比较此4种方程估算的GFR与r GFR的偏差、偏离程度、相关性、30%准确性和分期一致性差异。结果:669例CKD患者的r GFR水平为(61.78±26.51)m L/(min·1.73 m2);e GFR1与r GFR的偏差最小;各e GFR与r GFR的pearson相关系数在0.796~0.831之间,组内相关系数(ICC)在0.865~0.905之间,e GFR1与r GFR的相关性最佳;Bland-Altman图结果显示,e GFR1与r GFR的偏离程度最低、精确度最好;e GFR1和(或)e GFR2的总体30%准确性最高;各e GFR与r GFR总分期一致率在59.34%~63.98%之间,以e GFR1和(或)e GFR2最高,但一致性均不理想,Kappa值为0.437~0.490。结论:CKD-EPI2012SCr-SCys C更适于我国CKD患者GFR的预测,但仍需更大样本及多方面的研究验证。
[Abstract]:Objective: to evaluate whether the combined prediction equation of glomerular filtration rate (CKD-EPI2012SCr-SCys C) based on creatinine and cystatin C (CKD-EPI2012SCr-SCys C) reported by the American Association for Epidemiology of chronic Kidney Disease (CKD-EPI) in 2012 is higher than that reported in 2009 (CKD-EPI2009SCr-SCys C), China e GFR course). The combined prediction equations (Ma1 and Ma2) reported by Ma Yingchun et al in 2007 are more suitable for predicting GFR in (CKD) patients with chronic kidney disease in China. Methods: the data of 669 patients with CKD were collected. The GFR measured by 99m Tc-DTPA renal dynamic imaging was used as reference GFR (r GFR),. GFR was estimated by CKD-EPI2012SCr-SCys CCKD-EPI2009SCr-SCys CnMa1 and Ma2 (e GFR1e GFR2e GFR3 and e GFR4, respectively). The deviations between GFR and r GFR estimated by these four equations were compared. The accuracy of correlation was 30% and the consistency of stages was different. Results the r GFR level of 669 CKD patients was (61.78 卤26.51) mL / (min 1.73 m2) with minimum deviation from r GFR, and the pearson correlation coefficient between e GFR and r GFR was 0.796 ~ 0.831. The best correlation between GFR1 and r GFR was between 0.865 and 0.905. The results of Bland-Altman showed that the deviation between GFR1 and r GFR was the lowest, and the accuracy was the best for e GFR1 and / or e GFR2. The total consistent rate of e GFR and r GFR was between 59.34% and 63.98%, the highest was e GFR1 and / or e GFR2, but the consistency was 0. 437 0. 490. Conclusion the SCr-SCys C is more suitable for predicting the GFR of CKD patients in China, but it still needs a large sample and many studies to verify it.
【作者单位】：广州医科大学附属第五医院肾内科;广州市第一人民医院肾内科;
【分类号】：R692

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