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[儿科临床中常规使用的肾小球滤过率检测方法的有效性]

[Validity of routinely used methods of testing glomerular filtration in pediatric practice].

作者信息

Stejskal J, Nováková J, Reitschlägrová V

机构信息

Dĕtská klinika ILF, Praha.

出版信息

Cesk Pediatr. 1990 Nov;45(11):662-6.

PMID:2092916
Abstract

The authors compare different methods used commonly in paediatric practice to assess glomerular filtration (GFR)--creatinine clearance and assessment of GFR by means of Schwartz formula with plasma clearance of polyfructosan S (corresponds to inulin plasma clearance). A group of 108 children aged 4-16 years (x = 10.95) was examined. The patients were divided into three groups by the magnitude of polyfructosan S clearance: greater than 100 ml/min/1.73 m2; 50-100 ml/min/1.73 m2 and less than 50 ml/min/1.73 m2. The authors correlated the clearance of polyfructosan S with creatinine clearance and assessment of GFR according to Schwartz. The method which proved to be most sensitive for detection of reduced GFR in the area of 50-100 ml/min/1.73 m2 was creatinine clearance with urine collection one hour after a previous water load (r = 0.748). In the stage of chronic renal failure with GFR less than 50 ml/min/1.73 m2 the correlation was close with the three-hour creatinine clearance (r = 0.957) and equally close was the correlation with GFR according to Schwartz (r = 0.885). The authors discuss the probability of detection of impaired GFR by commonly used methods and draw attention to the advantages of examination of plasma clearance by polyfructosan S.

摘要

作者比较了儿科实践中常用的评估肾小球滤过率(GFR)的不同方法——肌酐清除率以及通过施瓦茨公式结合聚果糖S的血浆清除率(相当于菊粉血浆清除率)来评估GFR。对108名年龄在4至16岁(平均年龄x = 10.95岁)的儿童进行了检查。根据聚果糖S清除率的大小将患者分为三组:大于100 ml/min/1.73 m²;50 - 100 ml/min/1.73 m²;小于50 ml/min/1.73 m²。作者将聚果糖S的清除率与肌酐清除率以及根据施瓦茨公式评估的GFR进行了相关性分析。结果证明,对于检测50 - 100 ml/min/1.73 m²范围内GFR降低最敏感的方法是在前一次饮水负荷后1小时收集尿液的肌酐清除率(r = 0.748)。在GFR小于50 ml/min/1.73 m²的慢性肾衰竭阶段,与3小时肌酐清除率的相关性密切(r = 0.957),与根据施瓦茨公式评估的GFR的相关性同样密切(r = 0.885)。作者讨论了常用方法检测GFR受损的可能性,并提请注意通过聚果糖S检测血浆清除率的优势。

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