An Application Study Of Improved Formula Of Measurement Of The Glomerular Filtration Rate By Tc-99m DTPA Scintigraphy In Patients With Chronic Kidney Disease

Objective: This study based on Tc-99 m DTPA Gates method equation amended,revised formula [?ml/min?= renal uptake by 11.7773?%?-11.7773][1]measure GFR and chronic kidney disease CKD-EPIcr/cysc?2012?formula method to calculate the GFR comparison,evaluation correction formula in GFR detection in patients with chronic kidney disease?CKD?is more close to the real value.Method: Sixty-two patients diagnosed as CKD according to chronic kidney disease and without treatment in xingtai people's hospital from February 2016 to November 2016 were involved.The demographic data,including gender,age,height and weight,as well as clinical parameters,including serum creatinine?Scr?,urea nitrogen?BUN?,Cystatin C?Cys C?and other biochemical indicators were collected.Tc-99 m DTPA scintigraphy was conducted in the patients.Then both GFR calculated by the Gates' method original formula?gGFR?and GFR calculated by the improved Gates' method formula?pGFR?were compared to the eGFR calculated by CKD-EPI equation?CKD-EPI equation based on combined creatinine-cystatin,CKD-EPIcr/cysc?2012??and the relevant data was further analyzed.Linear correlation and regression method is used to describe the relationship between the gGFR and pGFR and eGFR,using Wilcoxon signed rank test,map Bland-Altman gGFR,pGFR were compared and the difference of eGFR and deviation degree.Computing gGFR pGFR and enter the percentage of eGFR plus or minus 15%,25% and 30% of cases,using chi-square test comparing the difference between the g GFR and pGFR.Result: Among sixty-two patients?male/female=29:33?with CKD,the mean age was 47.5 years old.Correlation analysis showed that both gGFR andpGFR significantly correlated with eGFR?r=0.94,p<0.01;r=0.94,p<0.01,respectively?.Wilcoxon signed rank test showed that,compared to gGFR,pGFR deviation and absolute deviation were improved significantly while significant improvement of the precision was not observed.By Bland-Altman map we found that gGFR deviation 95% forecast interval width was 55.2mL/min/1.73m2 while that of pGFR was 55.1 mL/min/1.73m2.Compared to gGFR,the accuracy of PGFR had not improved significantly.The deviation of gGFR and p GFR is respectively-17.8 and-1.0 mL/min/1.73m2 which indicate that the deviation of pGFR decrease significantly.P15,P25,P30 of gGFR and pGFR were calculated and the overall P15,P25,P30 of pGFR were better than the gGFR.Chi-square test showed that the P15 of pGFR had no significant difference?p=0.082?,while P25,P30 of p GFR had significant difference?p<0.01;p<0.01,respectively?,indicating that accuracy of pGFR is better than that of gGFR.Conclusion: ^99mTc-DTPA Gates method revised equation calculation of GFR and CKD-EPIcr/cysc?2012?formula method to calculate the GFR were significantly related,and the correlation coefficient is the same as the original equation calculation of GFR.The deviation of revised equation decrease obviously,the accuracy of the revised equation above the original equation,and its underestimate the degree of CKD-EPIcr/cysc?2012?equation also less than the original equation.The precision of the revised equation and the original equation is not obviously improved.