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目的探讨不同血糖水平对2型糖尿病患者肾小球滤过率(GFR)及其评估方程的影响方法选择经同位素~(99m)TC-DTPA测定GFR的2型糖尿病患者495例,HbA_1c与~(99m)Tc-DTPA测定GFR及CG方程、MDRD方程和MCQ方程GFR估计值之间进行相关性分析;以HbA1c=8%为临界值,比较两组间各评估方程的精确性和准确性。结果经同位素测定的GFR为(70.11±20.54)ml·min~(-1)·(1.73 m~2)~(-1),HbA_1 c与同位素测定GFR及CG方程、MDRD方程和MCQ方程GFR估计值呈正相关(r值分别为0.196、0.201、0.289和0.181,P<0.01)。无论血糖水平如何,CG方程的准确性都明显高于其他两个方程。结论近期高血糖增加同位素测定GFR和方程估算GFR的水平。虽然这些评估方程存在一些不足之处,但由于目前尚缺乏专门针对糖尿病人群的评估方程,在临床实际工作中采用CG方程来评估2型糖尿病患者的GFR不失为一个简便实用的方法。
Objective To investigate the effect of different blood glucose levels on glomerular filtration rate (GFR) and its assessment equation in patients with type 2 diabetes mellitus (DM). Methods 495 patients with type 2 diabetes mellitus (GFR) with isotope 99m Tc-DTPA, HbA 1c and ~ 99m) Tc-DTPA GFR and CG equation, MDRD equation and MCQ equation GFR estimates were analyzed; HbA1c = 8% was used as the cutoff to compare the accuracy and accuracy of the two evaluation equations. Results The GFR measured by isotope method was (70.11 ± 20.54) ml · min -1 (1.73 m 2) -1. GFR and GFR, MDRD and MCR equation of HbA 1 c and isotope were estimated by GFR (R values were 0.196,0.201,0.289 and 0.181 respectively, P <0.01). The accuracy of the CG equation is significantly higher than the other two equations, regardless of the blood glucose level. Conclusion Recent high blood glucose increased isotope determination of GFR and equation to estimate the level of GFR. Although these evaluation equations have some shortcomings, it is an easy and practical way to evaluate the GFR in patients with type 2 diabetes by using the CG equation in clinical practice due to the lack of assessment equations specifically targeting diabetic patients.