点时间尿微量白蛋白/尿肌酐比值与24h定量的临床评价  

Assessment of spot microalbuminuria-to-creatinine ratio from 24h microalbuminuria in clinical practice

作　　者：刘小玲[1] 张筠[1] 

机构地区：[1]重庆市急救医疗中心检验科,400014

出　　处：《重庆医学》2005年第10期1518-1520,共3页Chongqing medicine

摘　　要：目的确定随机尿微量白蛋白与尿肌酐比值(UmAlb/C)的临床正常参考值。研究随机UmAlb/C是否可以替代24h UmAlb定量,用于监测尿白蛋白的排出情况。探讨UmAlb/C在糖尿病肾功能损伤的诊治意义。方法选取本院住院患者31例,对其随机UmAlb/C与24h UmALB定量进行相关分析。应用受试者工作曲线(receiver operating characteristics,ROC),以24h UmAlb定量的正常参考值25mg/24h为标准,确定随机UmAlb/C的正常参考值。采用ROC曲线分析确定随机UmAlb/C相对于24h UmAlb定量≥60 mg及≥180 mg的诊断界点。再选取糖尿病患者组与正常对照组检测其UmAlb/C结果进行比较。结果随机尿mAlb/C与24h UmAlb定量高度相关。应用ROC曲线计算随机UmAlb/C的正常参考值为3mg/mmol Cr。计算随机UmAlb/C相应24h UmAlb定量60mg及180mg的诊断界点分别为8.75mg/mmol Cr及19.00mg/mmol Cr,敏感性为90.0%、86.0%,特异性为83.0%和91.0%。糖尿病患者的随机尿mAlb/C与正常对照组有显著性差异。结论监测尿白蛋白排出情况时,患者点时间UmAlb/C可以替代24h UmAlb定量。随机UmAlb/C的正常参考值为3mg/mmol Cr。随机UmAlb/C的检测对于糖尿病性肾病的早期诊断具有十分重要的意义。Objective To confirm the normal clinical value of random UmAlb ratio for consulting. To evaluate the clinical application of total UmAlb/c ratio in spot urine specimens as a predictor of 24h collections and to investigate the significance of UmAlb/c used for treating the lesion of diabetic kidney function. Methods Thirty-one specimens from patients were collected. The correla- tions between random UmAlb/c and UmAlb in 24h collections were analyzed. Applying the UmAlb of 25mg/24h in 24h collections as standard, the random normal value of UmAlb/C was determined by receiver operating characteristics （ROC）curve. The cutoff values of random UmAlb/C specimens for screening UmAlb≥60 and UmAlb≥180mg in 24h collections were determined by ROC curve. The specimens from diabetics and normal persons were obtainted to compared them with the result of UmAlb/C ratio. Results There was highly significant correlation between random UmAlb/C and UmAlb in 24h collections. By ROC curve analysis, the normal value of random UmAlb/C ratio was 3mg/mmol Cr. The UmAlb/C of 8.75mg/mmol Cr and 19.00mg/mmol, Cr in specimens to detect UmAlb of 60rag and 180rag in 24h collections repectively with the sensitivity 90.0 % and 86.0 %, the specificity 83.0% and 91.0%. There are noticeable difference of random UmAlb/C between disabetics and normal person. Conclusion The UmAlb/C in spot urine samples can be used as an alternative to urine protein excretion in 24h collections. The normal clinical value of random UmAlb/C ratio is 3mg/mmol Cr. The examination of random UmAlb/C ratio has important significance to early diagnosis of diabetic nephropathy.

关 键 词：微量白蛋白尿 尿微量白蛋白与肌酐比值 糖尿病性肾病 

分 类 号：R446.1[医药卫生—诊断学]