摘要
目的评估Cockcroft-Gault公式、MDRD方程7、简化MDRD方程、肌酐清除率（Ccr）对老年人群肾小球滤过率（GFR）的评定作用。方法选择我院老年干部门诊长期随诊无慢性肾脏病史患者167例，年龄60～91岁，男性血肌酐≤132．6μmol／L，女性≤114．9μmol／L，无高血压史或高血压长期控制良好者。按上述方法测定GFR，评价其与年龄、瘦体重的相关性；比较各方程测量老年人肾功能间的差异。结果167例中，男140例（83．8％），女27例（16．2％），平均年龄（76．2±6．4）岁，其中60～69岁25例（15％），70～79岁91例（54．5％），80～91岁51例（30．5％）。无慢性肾脏病者63例（37．7％），高血压已控制者104例（62．3％），平均血肌酐（104．3±14．1）μmol／L。Cockcroft—Gault公式计算GFR与年龄的相关性最好（r=0．665，P〈0．001）；Ccr值与瘦体重的相关性最好（r-0．838，P〈O．001）；Cockcroft-Gault公式计算GFR值、瘦体重随增龄而下降，不同年龄组之间两两比较，差异均有统计学意义；而Ccr、MDRD方程7、简化MDRD方程的GFR值随增龄亦有所下降，但组间差异无统计学意义。高血压控制组的GFR比老年对照组下降，用Ccr、简化MDRD方程和Cockcroft—Gault计算法的GFR值均降低，但仅Ccr和简化MDRD方程结果之间差异有统计学意义（P〈0．05）。结论各种方法计算GFR值均有随增龄呈下降趋势，其中Cockcroft—Gault公式与年龄、Ccr值与瘦体重均有较好的相关性。GFR值在老年高血压控制组比无高血压组低，但仅Ccr、简化MDRD方程结果差异有统计学意义。
Objective To compare Cockcroft-Gault equation, MDRD equation 7, abbreviated MDRD equation, and creatinine clearance （Ccr） in GFR prediction in elderly patients. Methods 167 patients in 60-91 years old were selected in this study, all patients had no chronic renal damage （CKD criteria according to NKF-K/DOQI guidelines）with serum creatitine（Scr）≤ 132.6 μmol/L （male）, Scr≤114.9μmol/L （female）. We computed the GFR value and evaluated its correlation with age and lean body mass （LBM） of four equations. According to patient＇s age, the patients were divided into three groups： 60-69 years, 70-79 years, 〉80 years old. We compared the difference of equations in GFR prediction in three groups. According to the diagnosed hypertension, we separated the patients into two groups and compared the difference in GFR prediction between the two groups. Results Among the studied 167 patients, there were 140（83.8%）males and 27（16.2%）females, with average age of（76. 2±6. 4） years. 25（15%）patients were 60-69 years old; 91（54.5%）were 70 -79 years, 51（30.5%）were〉80 years. The 104 patients had hypertension and 63 no hypertension. Average Scr level was（104.3 ± 14.1） μmol/L, in normal range. The correlation coefficients between Cockcroft-Gault equation and age was the best （ r = 0. 665, P〈 0. 001 ）. The correlation coefficients between Ccr and LBM was the best（r -0. 838, P〈0. 001）. The Cockcroft-Gault equation-computed GFR and LBM were secreased significantly with aging among each of the three groups（all P〈0. 001） . The GFR values of MDRD equation 7, abbreviated MDRD equation and Ccr were decreased with aging, but there was no significant difference among each of the three groups. Patients in the hypertension group showed a significant decrease in GFR prediction in Ccr and abbreviated MDRD equation（P〈0.05）. But the MDRD equation 7 and the Cockcroft-Gault equation revealed no change in GFR prediction between the two groups. Conclusions The levels of GFR predicted by all equationsare decreased with aging in elderly patients. The correlation coefficients between Coekeroft -Gault equation and age is the best, the correlation coefficients between Cer and LBM is the best. The level of GFR of the hypertension group showed a significant decrease in Cer and abbreviated MDRD equation. The results of four equations in GFR prediction in elderly patients are not completely identical. Coekeroft-Gault equation may be slightly more suitable for the elderly, but more investigation should be necessary.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2006年第1期25-28,共4页
Chinese Journal of Geriatrics
关键词
肾小球滤过率
体重与身体测量
高血压
Glomerular filtration rate
Body weights and measures
Hyperrension
