Si Hongwei, Lei Zhili, Han Chunlei, Wu Zhifang, Li Sijin
Department of Nuclear Medicine, First Affiliated Hospital of Shanxi Medical University, Taiyuan, China.
Department of Nuclear Medicine, First Affiliated Hospital of Anhui Medical University, Hefei, China.
Q J Nucl Med Mol Imaging. 2018 Jun;62(2):185-189. doi: 10.23736/S1824-4785.16.02714-X. Epub 2014 Jun 10.
Scaling glomerular filtration rate (GFR) to body surface area (BSA) has been widely accepted, and was debated in recent years. Although the indexation ability of BSA is inferior to other physiological variables, the evaluation of BSA formulae is still meaningful to clinical practice. In this study, to evaluate the indexation ability of BSA formulae, the repeated measures analyses of camera-based scintigraphy (Gates method, gGFR) and plasma-based clearance (pGFR) were used to specially focus on the between-subject variability that tried to be minimized by GFR normalization.
The patients, who were older than 18 y and suffered from renal diseases, were enrolled and grouped according to the Chinese BMI (body mass index) criteria. All patients accepted renal scintigraphy and plasma clearance examinations. The gGFR and pGFR were separately scaled to DuBois & DuBois, Boyd, Stevenson, Gehan, Haycock, Mosteller, Hu and Livingston and Lee's formula. In the repeated measures analyses, the intraclass correlation coefficient (ICC), concordance correlation coefficient (CCC) and the ratio of residual standard deviation to pooled standard deviation (RSD/PSD) were used for the evaluation.
During January 2010 and May 2012, 220 patients were enrolled. The evaluated BSA formulae had well correlated results and significant differences among BMI groups. From high to low, the sequence of the correlation between BMI and BSA formula was L-L, Haycock, Gehan, Boyd, Mosteller, Stevenson, Hu and DuBois & DuBois formula. Both the scaled indices (ICC and CCC) and RSD/PSD indicated that, the sequence of indexation ability of BSA equations was Livingston < Haycock < Gehan < Stevenson < Mosteller < Boyd < Hu < DuBois & DuBois.
Among the evaluated BSA formulae, DuBois & DuBois formula correlates to BMI the worst, and has the best indexation ability in scaling GFR of adult renal patients.
将肾小球滤过率（GFR）校正为体表面积（BSA）已被广泛接受，但近年来一直存在争议。尽管BSA的校正能力不如其他生理变量，但对BSA公式的评估对临床实践仍具有重要意义。在本研究中，为评估BSA公式的校正能力，采用基于相机的闪烁扫描法（Gates法，gGFR）和基于血浆的清除率（pGFR）的重复测量分析，特别关注试图通过GFR标准化来最小化的受试者间变异性。
纳入年龄大于18岁的肾病患者，并根据中国BMI（体重指数）标准进行分组。所有患者均接受肾脏闪烁扫描和血浆清除率检查。将gGFR和pGFR分别校正为杜波依斯与杜波依斯公式、博伊德公式、史蒂文森公式、格汉公式、海科克公式、莫斯特勒公式、胡公式以及利文斯顿和李公式。在重复测量分析中，使用组内相关系数（ICC）、一致性相关系数（CCC）以及残余标准差与合并标准差之比（RSD/PSD）进行评估。
2010年1月至2012年5月期间，共纳入220例患者。所评估的BSA公式结果相关性良好，且在BMI组间存在显著差异。从高到低，BMI与BSA公式的相关性顺序为利文斯顿与李公式、海科克公式、格汉公式、博伊德公式、莫斯特勒公式、史蒂文森公式、胡公式和杜波依斯与杜波依斯公式。校正指数（ICC和CCC）以及RSD/PSD均表明，BSA方程的校正能力顺序为利文斯顿公式 < 海科克公式 < 格汉公式 < 史蒂文森公式 < 莫斯特勒公式 < 博伊德公式 < 胡公式 < 杜波依斯与杜波依斯公式。
在所评估的BSA公式中，杜波依斯与杜波依斯公式与BMI的相关性最差，在对成年肾病患者的GFR进行校正时具有最佳的校正能力。
