放射免疫法 免疫比浊法及免疫试纸定性法检测尿微量白蛋白比较分析  

The comparison among three assays for detection of microalbuminuria

作　　者：欧香忠[1] 邓婉萍[1] 姚斌[1] 庞璨[1] 廖瑛[1] 翁建平[1] 

机构地区：[1]广东省糖尿病防治研究中心中山大学附属第一医院内分泌科,广东广州510080

出　　处：《中国实用内科杂志》2006年第11期1718-1720,共3页Chinese Journal of Practical Internal Medicine

基　　金：教育部2004年度"新世纪优秀人才支持计划"(NCET-04-0807)

摘　　要：目的比较3种尿微量白蛋白检测方法即免疫试纸定性法(Micral-Test)、免疫比浊法(DCA2000分析仪)和放射免疫法检测结果的一致性,评价其诊断价值。方法2003年9月至2005年5月收集中山大学附属第一医院应用Micral-Test试纸结果阳性或可疑阳性的133例糖尿病患者,留取随机尿和过夜8h尿进行Micral-Test试纸定性法、放射免疫法和DCA2000分析仪3种方法检测尿微量白蛋白。结果(1)放射免疫法尿微量白蛋白浓度质量(Alb)和尿微量白蛋白排泄率(AER)的检测值明显低于DCA2000分析仪(P<0.01),后者AER的灵敏度和特异度分别为100%和86.2%,κ=0.812。(2)随机尿和过夜尿的Micral-Test试纸判读结果ROC曲线下面积(AUC):0.900对0.934。(3)随机尿尿微量白蛋白与尿肌酐比值(ACR)和Alb的AUC分别为0.952对0.923;而过夜尿ACR和Alb的AUC分别为0.965对0.958。结论3种尿微量白蛋白检测方法的诊断价值均较高。Micral-Test试纸适用于尿微量白蛋白初步筛选,尿ACR尚不能代替尿AER作为诊断标准,DCA2000分析仪较放射免疫法精确。Objective To evaluate the consistency and diagnosis importance among three assays of Micral -Test strip, DCA 2000 analyzer and radioimmunoassay. Methods A total of 133 random urine samples of patients with diabetes were determined positive or questionable positive by Micral -Test strip, from whom urine samples within 8 hours during the nighttime were also collected. Both the two urine samples were determined by three assays for detection of microalbuminuria. Results （1） The value of Alb and AER determined by radioimmunoassy was significantly lower than that by DCA2000 analyzer, of which the sensitivity and specificity is 100% and 86.2% , K = 0. 812. （2） According to the reading scales of Micral - Test strip, the area under ROC curve （AUC） of random and 8 h urine samples were 0. 900 and 0. 934 respectively. （3） The AUC of random ACR and Alb was 0. 952 and 0. 923. The AUC of 8h urine ACR and Alb were 0. 965 and 0. 958. Conclusion The diagnosis importance among three assays is all dependable. Micral - Test strip is convenient for screening. ACR cannot substitute for AER as a diagnosis standard. And the value determined by DCA 2000 analyzer is more precise than that of radioimmunoassay.

关 键 词：尿微量白蛋白 Mieral—Test试纸 DCA2000分析仪 

分 类 号：R5[医药卫生—内科学]