目的：通过估测肾小球滤过率（e-GFR）来评估急性脑卒中患者的肾功能变化情况。方法选择100例急性脑卒中患者为研究对象，其中男女患者各50例，≥50岁58例，＜50岁42例。患者均于住院次日采血测定肌酐水平。采用简化肾脏膳食改良试验（MDRD）法计算e-GFR，按照肾脏病患者生命质量指导（K/DOQI）评估100例急性脑卒中患者的肾功能，并与血肌酐结果进行对照。从年龄、性别方面分析急性脑卒中患者e-GFR的差异。结果以GFR＜90 ml/（min ·1.73 m^2）判定为肾功能降低，100例患者中56.0%（56/100）存在肾功能减低。以肌酐〉124μmol/L判定肾功能降低，100例患者中仅4.0%（4/100）存在肾功能减低。≥50岁患者e-GFR异常率高于〉50岁患者[93.1%（54/58）比4.8%（2/42）]，差异有统计学意义（χ^2=77.16，P〉0.01）。不同性别患者e-GFR异常率比较差异无统计学意义[54.0%（27/50）比58.0%（29/50）]（P〉0.05）。结论急性脑卒中患者中普遍存在肾功能下降，检测e-GFR可以更准确地评估患者的肾功能，为个体化选择药物提供依据。
Objective To evaluate the change of renal function in patients with acute stroke by estimate glomerular filtration rate （e-GFR）. Methods One hundred patients with acute stroke admitted into hospital from emergency department in 72 h were enrolled. There were 100 patients, with 50 male patients and 50 female patients. Fifty-eight patients were older than 50 years old, and 42 patients were less than 50 years. Blood samples were collected from the next day in hospital to detect the level of creatinine （Cr）, then e-GFR was calculated with a simplified method of modification of diet in renal disease. According to the National Kidney Foundation published kidney disease outcome quality initiative （K/DOQI）, the renal function of these 100 patients was estimated. The outcome of e-GFR and Cr were compared. The differences of e-GFR in patients with acute stroke were analyzed from the aspects of age and gender. Results 56.0% （56/100） patients were determined as decreased renal function according to the standard of GFR〈90 ml/（min ·1.73 m^2）. 4.0% （4/100） patients were determined as decreased renal function according to the standard of Cr〉 124μmol/L. The abnormal rate of e-GFR in patients older than 50 years old was 93.1%（54/58）, in patients less than 50 years old was 4.8%（2/42）, and there was significantly difference （χ^2=77.16, P〈0.01）. The abnormal rate of e-GFR in male and female had no significantly difference： 54.0%（27/50） vs. 58.0% （29/50）, P 〉 0.05. Conclusions The decreased renal function in patients with acute stroke is common. The detection of e-GFR can more accurately assess the patient′s renal function and provide a basis for individual choice of drugs.
Chinese Journal of Postgraduates of Medicine
Glomerular filtration rate