| 王旭方,陈继红,江燕,等.慢性肾脏病流行病合作工作组方程在慢性肾脏病2~3期老年患者肾功能评估中的意义[J].安徽医药,2018,22(6):1046-1050. |
| 慢性肾脏病流行病合作工作组方程在慢性肾脏病2~3期老年患者肾功能评估中的意义 |
| Application of the CKD-EPI equation for estimation of glomerular filtration rate in elderly Chinese patients with chronic kidney disease stage 2-3 |
| 投稿时间：2017-03-04 |
| DOI： |
| 中文关键词: 肾功能不全,慢性 肾小球滤过率 老年人 慢性肾脏病流行病合作工作组方程 |
| 英文关键词: Renal insufficiency,chronic Glomerular filtration rate Aged The chronic kidney disease epidemiology collaboration |
| 基金项目:江苏省科技厅课题(BL2012032)；国家中医药管理局课题(JDZX2015093) |
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| 中文摘要: |
| 目的 评价3种慢性肾脏病流行病合作工作组 (the chronic kidney disease epidemiology collaboration,CKD-EPI) 方程在慢性肾脏病(chronic kidney disease ,CKD)2 ~ 3期老年患者肾小球滤过率(glomerular filtration rate,GFR)评估中的意义。方法回顾分析2010年1月至2015年1月在江苏省中医院住院的老年CKD2~3期患者81例,收集临床资料,以3种CKD-EPI方程估算GFR,记录为EPI- 血肌酐(EPI-serum creatinine,EPI-SCr)、EPI-胱抑素C(EPI-cystatin C,EPI-CysC)和EPI-肌酐联合胱抑素C(EPI-serum creatinine-cystatin C,EPI-SCr-CysC),以锝[99mTc]标记的喷替酸盐(Technetium [99mTc] Pentetate ,99mTc-DTPA) 肾动态显像为金标准,比较3种方程评价CKD2~3期老年患者GFR水平的适应性、灵敏度及准确度。结果 CKD2~3期老年人群中,与EPI-SCr方程相比, EPI-CysC及EPI-SCr-CysC方程提高了适用性,且其优势主要体现在CKD3期；依据EPI-CysC及EPI-SCr-CysC方程结果对老年患者进行CKD分组,其灵敏度(39.22%比90.20%比86.27%,P<0.001)及准确度(55.56%比82.72%比82.72%,P <0.001)更高,但三个方程特异度之间差异无统计学意义(83.88%比70.00%比76.67%,P=0.475)。结论 联合CysC的CKD-EPI方程对CKD2~3期老年患者GFR评估和CKD分期更具指导意义。 |
| 英文摘要: |
| Objective To evaluate the applicability of the estimation equation of glomerular filtration rate in elderly patients with chronic kidney disease (CKD) stage 2-3.Methods Eighty-one hospitalized elderly patients with CKD stage 2-3 were retrospectively analyzed who were admitted,from January 2010 to January 2015,in Jiangsu Provincial Hospital of Chinese Medicine.Clinical data were collected.The glomerular filtration rate (GFR) was estimated by three CKD-EPI equations,and EPI-serum creatinine (EPI-SCr),EPI-cystatin C (EPI-CysC) and EPI-serum creatinine-cystatin C (EPI-SCr-CysC) were recorded.Technetium [99mTc] Pentetate (99mTc DTPA) renal dynamic imaging results were considerd to be the golden standard.The applicability,sensitivity and accuracy of the three equations in the evaluation of GFR levels in patients with CKD stage 2-3 were compared.Results Compared with EPI-SCr,EPI-CysC and EPI-SCr-CysC equation improved the applicability,which were mainly reflected in the CKD3 stage.CKD was classified according to the results of EPI-CysC and EPI-SCr-CysC equation,and elderly patients with CKD3 had better consistency (39.22% vs 90.20% vs 86.27%,P<0.001) and greater accuracy (55.56% vs 82.72% vs 82.72%,P <0.001).But,there was no statistical difference in the specificity among three equations(83.88% vs 70.00% vs 76.67%,P=0.475).Conclusions The CKD-EPI equation combined with CysC is more instructive for GFR assessment and CKD staging. |
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