对两小时肌素清除率和C-G公式进行对重症患者功能评估的比较分析
Congyou Liu1, Xingyun Zhu2, Xinzhu Guo1
1Department of Intensive Care Unit, Beijing Jishuitan Hospital, Capital Medical University, 31 East Xinjiekou Street, Xicheng District, Beijing, 100035, China.
Heliyon
|May 31, 2024
概括
与Cockcroft-Gault公式 (CrC-G) 相比,2小时肌素清除率 (Ccr2) 在重症患者中提供了更准确和及时的功能评估. 这种方法可以更好地反映实时功能变化.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 临床化学 临床化学
背景情况:
- 准确评估功能对于管理重症患者至关重要.
- 像Cockcroft-Gault公式 (CrC-G) 这样的传统方法可能无法在动态的临床环境中及时或精确地估计功能.
- 建议使用2小时肌素清除率 (Ccr2) 作为一种潜在的优质替代方案.
研究的目的:
- 评估2小时肌素清除率 (Ccr2) 的精度和及时性,以评估重症患者的功能.
- 为了比较Ccr2的性能与已建立的Coccroft-Gault公式 (CrC-G) 和24小时肌素清除率 (Ccr24).
主要方法:
- 一项队列研究涉及74名危急病患者超过6个月.
- 采集316个2小时的尿样,并采集24小时的尿样.
- 分析Ccr2,CrC-G和Cr24之间的相关性和一致性,包括变化速率 (ΔCcr2和ΔCrC-G).
主要成果:
- Ccr2与Ccr24相关时,与CrC-G (R值高达0.828) 相比,Ccr2显示出更高的相关性 (R值高达0.886) 和较低的偏差.
- 在检测功能快速变化时,Ccr2的灵敏度显著提高 (在92%的患者中,ΔCcr2≥20%,而在40%的患者中,ΔCrC-G≥20%).
- 在患有高功能 (Ccr24 ≥120毫升/分钟/1.73米2) 的患者中,Ccr2与CrC-G不同,Ccr2与Ccr24非常接近.
结论:
- 2小时肌素清除值 (Ccr2) 是严重病患者功能的一个更准确和及时的指标,而不是Cockcroft-Gault公式 (CrC-G).
- 在重症监护机构中,Ccr2为实时监测和管理功能提供了有价值的工具.
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