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ื”ื•ืจื“ื•ืช
ืกื™ื•ื•ื’ ืชื•ื›ืŸ
ื›ื•ืœื
ืฆื™ืœื•ื ืžืกืš
ืฆื™ืœื•ื ืžืกืš

ืžื™ื“ืข ืขืœ ื”ืืคืœื™ืงืฆื™ื” ื”ื–ื•

ืคื™ื ื•ื™ ืื™ื ื•ืœื™ืŸ ื”ื•ื ืฉื™ืขื•ืจ ืชืงืŸ ื–ื”ื‘ ืกื™ื ื•ืŸ ื’ืœื•ืžืจื•ืœืจื™ (GFR) ืžื—ื•ืฉื‘, ื”ืœื™ืš ื‘ื“ื™ืงื” ืžืกื•ื‘ืš, ื‘ืขื™ืงืจ ืืฆืœ ื™ืœื“ื™ื. ืขื“ ื›ื”, ื™ืฉ ืœื ื• ื‘ืฉื™ืžื•ืฉ GFR (EGFR) ืืžื™ื“ืช ืžืฉื•ื•ืื” ืขืœ ืžื ืช ืœื”ืขืจื™ืš ืืช ืชืคืงื•ื“ ื”ื›ืœื™ื” ื‘ื™ืœื“ื™ื ื‘ืงืœื•ืช ื‘ืชืจื’ื•ืœ ื™ื•ืžื™.
ืขื ื–ืืช, ืžืฉื•ื•ืืช ืฉื•ื•ืจืฅ ื”ืขืจื›ื” ืœืฉืขื‘ืจ, ืฉื”ื™ื ืœืžื˜ืจื•ืช ื›ืœืœื™ื•ืช ืขื“ ื›ื”, ื™ืฉ ื‘ืขื™ื” ื›ื™ ื”ืฉื™ื˜ื” ื™ืคื” ื•ืœื ื‘ืฉื™ื˜ื” ืื ื–ื™ืžื˜ื™ืช ื‘ื™ ืงืจื™ืื˜ื™ื ื™ืŸ ื‘ืกืจื•ื ืžื“ื™ื“ื•ืช (ื™ื-CR) ื”ื™ื• ื‘ืฉื™ืžื•ืฉ ื‘ื™ืคืŸ ืขื›ืฉื™ื•, ืžืฉื•ื•ืืช ืืžื™ื“ื” ื—ื“ืฉื” ืฉื•ื•ืจืฅ ื‘ืฉื™ื˜ืช ื”ืื ื–ื™ื ื–ื” ืชื•ืงืŸ, ืื‘ืœ ืœื ื”ื™ื” ื‘ืขื™ื” ืฉืœ ืฉื™ืžื•ืฉ ื‘ื’ื•ืจื ืžืฉื•ืชืฃ ื‘1 ื‘ืช ืœ16 ื‘ืŸ, ื›ื•ืœืœ ื’ื™ืœ ื”ื”ืชื‘ื’ืจื•ืช ื›ื“ื™ ืœื”ื’ื“ื™ืœ ื‘ืžื”ื™ืจื•ืช ื‘ืžืกืช ืฉืจื™ืจ. ื™ืฉ ื’ื ื”ื‘ื“ืœ ื‘ืžืกืช ืฉืจื™ืจ ื•ืชืคืงื•ื“ ื”ื›ืœื™ื™ืชื™ ืขืœ ืคื™ ื’ื–ืข. ืœื›ืŸ, ืื ื• ื ืขืฉื• ื™ืฆื™ืจืช eGFR ืฉืœ ืฉื ื™ ืกืคืฆื™ืคื™ื™ื ื™ืคื ื™.

EGFR ืฉืœ ืฉื™ืžื•ืฉ ื™ s-CR ื”ื™ืœื“ื™ื ื”ื™ืคื ื™ื
2 ืฉื ื™ื ืœ18 ืฉื ื™ื, ื‘ื—ืœื•ืงื” ืœื’ื‘ืจื™ื ื•ื ืฉื™ื, ืœืงื‘ื•ืข ืืช ืขืจืš ื”ืชื™ื™ื—ืกื•ืช ืงืจื™ืื˜ื™ื ื™ืŸ ื‘ืกืจื•ื (ื "ืฆ Cr) ืžื’ื•ื‘ื” ื›ืžืชื•ืืจ ืœื”ืœืŸ. ื™ืฉ ืœื™ ืฉืžื•ืฆื’ ืœื”ืœืŸ ื”ืžืืžืจ.
ื›ืืฉืจ HT (ืž ') ื•ื”ื’ื•ื‘ื” ืขื‘ื•ืจ ื”ื‘ื ื™ื,
ื "ืฆ Cr =-1.259Ht5 7.815 HT4-18.57Ht3 21.39 HT2-11.71Ht 2.628
ื›ืืฉืจ HT (ืž ') ื•ื”ื’ื•ื‘ื” ืขื‘ื•ืจ ื‘ื ื•ืช,
ื "ืฆ Cr =-4.536Ht5 27.16 HT4-63.47Ht3 72.43 HT2-40.06Ht 8.778
ื”ืื ื‘ื—ื™ืฉื•ื‘,
eGFR (ml/min/1.73m2) = 110.2 ร— (ื "ืฆ Cr / s-CR) 2.93
EGFR ื™ื”ื™ื” 5101.
ืœืžืจื‘ื” ื”ืฆืขืจ, ืืชื” ืœื ืชื•ื›ืœ ืœื”ืฉืชืžืฉ ื‘eGFR ืฉืœ ืฉื™ืžื•ืฉ ืฉืœ-CR ื‘2 ืฉื ื™ื.
ย 
EGFR ืฉืœ ืฉื™ืžื•ืฉ cysC ืฉืœ ื”ืฉื ื™. ื™ืœื“ื™ื ื™ืคื ื™ื™ื
ืื ื™ ื™ืฆืจืชื™ eGFR ื‘ืืžืฆืขื•ืช cysC. EGFR ื™ื”ื™ื” ืžื—ื•ืฉื‘ ืขืœ ื™ื“ื™ ื”ื ื•ืกื—ื” ืœื—ื•ื“ืฉ ื”ื‘ืื” ื›ื“ื™ 18 ืฉื ื™ื. ื™ืฉ ืœื™ ืฉืžื•ืฆื’ ืœื”ืœืŸ ื”ืžืืžืจ.
eGFR (m2 mL/min/1.73) = 104.1 ร— 1/serum cysC (ืž"ื’ / ืœื™ื˜ืจ) - 7.80

ื‘ื ื•ืกืฃ, ืขืœ ืžื ืช ืœื“ืขืช ืื GFR ื—ืจื™ื’ ืฉื ื“ืจืฉ ืื ื ื“ืจืฉ ืขืจืš ื”ื”ืชื™ื™ื—ืกื•ืช ื”ื ื•ืจืžืœื™ ืฉืœ GFR. ื™ืฉ ืœืš ื™ืฆืจ ื˜ื‘ืœืช ืขืจืš ื™ื™ื—ื•ืก GFR ืขืœ ื™ื“ื™ ื”ืฆื‘ืช ื‘ื”ืขืจื›ืช ืžืฉื•ื•ืื” ืฉืœ ื ืชื•ื ื™ื ื‘ืขืช ื™ืฆื™ืจืช ืขืจืš ื™ื™ื—ื•ืก ืฉืœ cysC ื•s-CR ืฉืœ ื™ืœื“ื™ื ื™ืคื ื™ื™ื ื‘ืขื‘ืจ. 18 ืฉื ื™ื ื•ืžืชื—ืช ืœื’ื™ืœ 2 ื•ืžืขืœื” ื‘eGFR ื‘ืืžืฆืขื•ืช s-CR, ื•ื›ืคื™ ืฉื—ื•ืฉื‘ ื‘eGFR ืฉืœ ืฉื™ืžื•ืฉ cysC 2 ืฉื ื™ื 3 ื—ื•ื“ืฉื™ื ืื• ื™ื•ืชืจ, ืื™ืŸ ืขืจืš ื™ื™ื—ื•ืก ืฉืœ ืคื—ื•ืช ืžืฉืœื•ืฉื” ื—ื•ื“ืฉื™ื.
ื”ืชืจืื” ืฉืœ ื“ืžื•ืช ืฆื”ื•ื‘ื” ื”ืคื›ื” ื›ืœ ื›ืš ืžื’ื™ืจืขื•ืŸ ื”ืชืจืื”, ืื ืคื—ื•ืช ืž 75% ืื ืคื—ื•ืช ืž 50% ืžืชืคืงื•ื“ ื›ืœื™ื™ืชื™ ืชืงื™ืŸ. ืื ื™ ื—ื•ืฉื‘ ืฉื™ื™ืฉื•ื ื–ื” ืžื ื•ืฆืœ, ื—ื•ืœื™ ืžื—ืœืช ื›ืœื™ื•ืช ื›ืจื•ื ื™ืช ื‘ื™ืœื“ื™ื ื”ื•ื ื’ื™ืœื•ื™ ืžื•ืงื“ื ื•ื˜ื™ืคื•ืœ ืžื•ืงื“ื, ื•ืื ืื•ืฉืจ Tsunagare ืžื‘ื ื™ื•.

ืขื™ืชื•ืŸ
. 1 ืื•ืžื•ืจื” O, ื ื’ืื™ T, Ishikura K, et al: ... ืžืฉื•ื•ืื” ืžื‘ื•ืกืกืช ืงืจื™ืื˜ื™ื ื™ืŸ ืœื”ืขืจื™ืš ืืช ืงืฆื‘ ื”ืกื™ื ื•ืŸ ื”ื’ืœื•ืžืจื•ืœืจื™ ื‘ื™ืœื“ื™ื ื•ื‘ื ื™ ื ื•ืขืจ ื™ืคื ื™ื™ื ืขื ืžื—ืœืช ื›ืœื™ื•ืช ื›ืจื•ื ื™ืช Clin Exp Nephrol 2013 ืกืคื˜ืžื‘ืจ 7 [Epub ืœืคื ื™ ื”ื”ื“ืคืกื”]
. 2 ืื•ืžื•ืจื” O, ื ื’ืื™ T, Ishikura K, et al: ... ืžืฉื•ื•ืื” ืžื‘ื•ืกืกืช C cystatin ืœื”ืขืจื™ืš ืงืฆื‘ ืกื™ื ื•ืŸ ื’ืœื•ืžืจื•ืœืจื™ ื‘ื™ืœื“ื™ื ื•ื‘ื ื™ ื ื•ืขืจ ื™ืคื ื™ื™ื Clin Exp Nephrol 2013 ื ื•ื‘ืžื‘ืจ 20 [Epub ืœืคื ื™ ื”ื”ื“ืคืกื”]
ืขื“ื›ื•ืŸ ืื—ืจื•ืŸ ื‘ืชืืจื™ืš
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ื›ื“ื™ ืœืฉืžื•ืจ ืขืœ ื”ื‘ื˜ื™ื—ื•ืช ืฆืจื™ืš ืงื•ื“ื ื›ืœ ืœื”ื‘ื™ืŸ ืื™ืš ื”ืžืคืชื—ื™ื ืื•ืกืคื™ื ื•ืžืฉืชืคื™ื ืืช ื”ื ืชื•ื ื™ื ืฉืœืš. ื ื•ื”ืœื™ ืคืจื˜ื™ื•ืช ื”ื ืชื•ื ื™ื ื•ืื‘ื˜ื—ืช ื”ื ืชื•ื ื™ื ืขืฉื•ื™ื™ื ืœื”ืฉืชื ื•ืช ื‘ื”ืชืื ืœืฉื™ืžื•ืฉ, ืœืื–ื•ืจ ื•ืœื’ื™ืœ ื”ืžืฉืชืžืฉ. ื”ืžืคืชื— ืกื™ืคืง ืืช ื”ืžื™ื“ืข ื”ื–ื” ื•ื”ื•ื ืขืฉื•ื™ ืœืขื“ื›ืŸ ืื•ืชื• ืžื“ื™ ืคืขื.

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