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目的:研究血清β痕迹蛋白(βtrace protein,BTP)在肾小球滤过功能评估中的价值。方法:收集2004年2月至2005年4月间我科住院的慢性肾脏病患者108例,男:57例,女:51例,平均年龄(50.39±15.37)岁,以改进的免疫比浊法,测定BTP浓度。同时检测血肌酐(SCr)、血清胱抑素C(cystatin,CysC)、同位素99mTc-GFR(GFR),并用CG公式计算肌酐清除率(Ccr)、MDRD公式计算肾小球滤过率(eGFR)。以GFR为金指标,对上述检测方法行相关分析及受试者工作特征曲线(ROC曲线)分析,计算ROC曲线下面积(AUC),比较各种检测方法的准确性,用四格表的卡方检验进行关联性的研究。结果:108例患者,血清BTP、Cys C、Ccr、eGFR和SCr的检测结果与GFR比较具有很好的相关性,相关系数分别为:-0.70、?0.82、0.79、0.81和?0.67,P均<0.01。BTP、CysC、eGFR、Ccr、SCr的AUC分别为0.913、0.889、0.878、0.864、0.846。在GFR<90 ml/min时,BTP、Cys C、Ccr、eGFR、SCr的诊断符合率分别是:86.11%、86.11%、92.59%、89.81%,72.22%。在GFR<60 ml/min时,其他指标的诊断符合率分别是BTP:81.5%、Cys C:79.6%、Ccr:76.8%、eGFR:77.7%,SCr:81.5%。结论:Ccr、eGFR与同位素99mTc-GFR等具有良好的相关性;BTP敏感性优于SCr;BTP检测方法简便快速,可作为评价肾功能不全的一项新指标,但仍需进一步研究。
Objective: To investigate the value of βtrace protein (BTP) in the assessment of glomerular filtration function. Methods: A total of 108 patients with chronic kidney disease admitted from February 2004 to April 2005 in our department were enrolled. They included 57 males and 51 females with an average age of (50.39 ± 15.37) years and improved immunoturbidimetry , Determine the BTP concentration. Serum creatinine (SCr), serum cystatin C (CysC) and isotope 99mTc-GFR (GFR) were measured at the same time. The creatinine clearance rate (Ccr) was calculated by CG formula and the glomerular filtration rate (eGFR) . Using GFR as the gold index, we analyzed the above detection methods and the receiver operating characteristic curve (ROC curve), calculated the area under the ROC curve (AUC), and compared the accuracy of various detection methods. Party test for the study of relevance. Results: There was a good correlation between serum BTP, Cys C, Ccr, eGFR and SCr in 108 patients and GFR. The correlation coefficients were -0.70, 0.82, 0.79, 0.81 and 0.67, respectively <0.01. The AUC of BTP, CysC, eGFR, Ccr and SCr were 0.913, 0.889, 0.878, 0.864 and 0.846, respectively. The diagnostic coincidence rates of BTP, Cys C, Ccr, eGFR and SCr at GFR <90 ml / min were 86.11%, 86.11%, 92.59%, 89.81% and 72.22%, respectively. At GFR <60 ml / min, the diagnostic compliance rates for other markers were 81.5% for BTP, 79.6% for Cys C, 76.8% for Ccr, 77.7% for eGFR and 81.5% for SCr. Conclusion: Ccr and eGFR have good correlation with isotope 99mTc-GFR. BTP sensitivity is better than SCr. BTP detection method is simple and rapid, which can be used as a new index to evaluate renal insufficiency. However, further study is needed.