摘要
目的：研究2型糖尿病患者不同时间点尿白蛋白／肌酐比值（ACR）与24h尿白蛋白（24huA）的相关性，探讨采用不同时间点尿ACR替代24huA用于2型糖尿病早期肾损伤筛查的应用价值。方法：收集89例住院2型糖尿病患者24h尿及不同时间点尿（主要是晨尿和随机尿）标本，比较不同时间点尿ACR与24hUA的相关性、诊断敏感度及特异度；同时以24huA为标准，建立不同时间点尿ACR的ROC曲线，并比较ROC曲线下面积。结果：不同尿液留取方式中晨尿及随机尿ACR分别为9．02（5．69。11．64）mg／mmol及8．65（5．80-11．83）mg／mmol，组间比较差异无统计学意义（Z=1．107，P〉0．05）。随机尿ACR与晨尿ACR相关分析显示两者呈高度相关（r=0．951，P〈0．01）；晨尿ACR、随机尿ACR与24huA均具有高度相关性，r分别为0．886及0．859（P〈0．01）；晨尿ACR诊断白蛋白尿的敏感度及特异度分别为92．6％及87．5％，随机尿ACR分别为90．1％及87．5％，两者相近。以24hUA作为判断标准，进行ROC曲线分析显示，晨尿、随机尿ACR的ROC曲线下面积分别为（0．954±0．022）及（0．960±0．021），组间比较差异无统计学意义（Z=1．107，P〉0．05）。结论：晨尿及随机尿ACR与24huA均具有较好的相关性．均可替代24hUA。但因随机尿ACR更方便留取尿液标本，可以较好地替代24hUA作为2型糖尿病早期肾损伤的筛查及监测指标．
Objective To investigate the application of using urine ACR at different time points instead of 24-hour urinary albumin （24 h UA） for screening of early renal injury in patients with type 2 diabetes. Methods The 24-h urine samples at different time pointsfrom 89 hospitalized patients were collected. The correlations of the ACR of urine samples at different time points were compared with the 24-h UA. When the 24-h UA was taken as the standard, the receiver operating characteristic （ROC） curves of urine ACR at different time points were established and analized. Results No significant differences in urine ACR between the morning urine group [ACR 9.02（5.69 ± 11.64）mg/mmol] and the random urine group [ACR 8.65（5.80 ± 11.83） mg/mmol] （P 〉 0.05）. A positive correlation was observed between the morning urine ACR and the random urine ACR （r = 0.951 ,P 〈 0.01）, however, the ACR of the morning and the random urine group were all positively correlated with the 24-h UA （r = 0.886, 0.859, P 〈 0.01 ）. There were no significant differences in the sensitivities and the specifieities between the morning and the random urine specimens in screening for albuminuria （92.6% vs 90.1%, and 87.5% vs 87.5%, respectively）. When the 24-h UA was taken as the standard,the area under the ROC curves of the ACR in the random urine specimens and the morning urine specimens were 0.954± 0.022 and 0.960± 0.021, respectively. There were no statistical differences between these two groups. Conclusions The morning urine and the random urine ACR, instead of the 24-h UA, could be used for both the early screening and monitoring of the renal injury, and the random urine ACR detection is simple, convenient and accurate for patients.
出处
《实用医学杂志》
CAS
北大核心
2014年第19期3172-3175,共4页
The Journal of Practical Medicine
基金
阜阳市卫生局医学科研课题(编号:201327)
关键词
糖尿病
2型
随机尿ACR
晨尿ACR
24
h尿白蛋白
早期肾损伤
Diabetes mellitus, type 2
Random urine albumin to creatinine
Morning urine albumin to creatinine
24 hour urinary albumin
Early renal injury
