哪个是最好的膜过标志物:肌素,囊素C还是两者兼而有之?
Thomas Stehlé1,2, Pierre Delanaye3,4
1Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire «Innovative therapy for immune disorders», Créteil, France.
European journal of clinical investigation
|July 1, 2024
概括
使用肌素或囊素C估计膜过率 (GFR) 有局限性. 结合这两种生物标志物可提供更准确的GFR估计,识别心血管事件和死亡率高风险患者.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 生物标志物 生物标志物
- 功能评估 功能评估
背景情况:
- 淋巴膜过率 (GFR) 估计通常使用肌素和囊素C.
- 最近的方程 (CKD-EPI 2021,EKFC 2021/2023) 完善了GFR估计,删除了种族因素并纳入可定制的人口数据.
- 在较新的GFR估计方程中,Q值允许对人口进行特定校准.
研究的目的:
- 审查肌素和囊素C作为GFR估计生物标志物的优缺点.
- 评估当前GFR估计方程的准确性和局限性.
- 突出结合生物标志物的好处,以改善GFR评估.
主要方法:
- 关于GFR估计生物标志物的现有文献的叙述性综述.
- 对影响肌素和囊素C水平的非GFR决定因素的分析.
- 在不同的方程和生物标志物中比较GFR估计准确度.
主要成果:
- 肌素受肌肉质量,蛋白质摄入量和管状分泌的影响.
- 赛斯塔丁C受甲状腺功能和皮质类固醇使用的影响,还有其他争论的因素.
- 单个生物标志物方程式的准确性有限 (在所有年龄段的病例中<90%的GFR测量在30%以内).
结论:
- 结合肌素和囊素C可以提高GFR估计的准确性,特别是在不一致的情况下.
- 具有高度不一致的生物标志物估计的患者代表了一个高风险子组.
- 在这个小组中,准确的GFR估计对于确定心血管发病率和死亡率增加的风险至关重要.
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