尿浓缩和稀释对随机尿微量白蛋白/肌酐比值结果的影响  

Effect of urine concentration and dilution on the results of random urine protein and creatinine ratio

作　　者：黄志宏[1] 付文金[1] 徐娜媚[1] 方海畴[1] 方爱娟[1] 陈楚填[1] 

机构地区：[1]广东医学院附属东莞市厚街医院,广东东莞523945

出　　处：《热带医学杂志》2013年第6期762-764,共3页Journal of Tropical Medicine

基　　金：东莞市重点课题项目(2012105102013)

摘　　要：目的探讨尿浓缩和稀释对随机尿蛋白和肌酐比结果的影响。方法选取慢性肾脏病人213例,按照随机尿肌酐(Ucr)浓度分为5组,A组:35例,Ucr≤2000mmol/L;B组:33例,2000mmol/L<Ucr≤3000mmol/L;C组:46例,3000mmol/L<Ucr≤7000mmol/L;D组:58例,7000mmol/L<Ucr≤15000mmol/L;E组:41例,Ucr>15000mmol/L。所有病例均测定尿蛋白/尿肌酐比值(UACR)和24h尿蛋白定量(24hUTP)水平,对各组UACR和24hUTP进行相关分析和Kappa检验。结果 B、C、D组患者随机尿UACR与24hUTP呈高度相关且一致性较强,r值分别为0.836、0.886、0.868,Kappa值分别为0.762、0.758、0.753;而A、E组两者呈较低相关且一致性较差。B、C、D组总的r和Kappa值分别为0.887和0.757,仍具有较高的相关性和中度一致性。结论慢性肾病患者在随机尿2000mmol/L<Ucr≤15000mmol/L时,UACR可作为24hUTP定量检测的初筛实验;而在Ucr≤2000mmol/L和>15000mmol/L时,随机尿UACR结果不可靠。Objective To explore the effect of urine concentration and dilution on the results of random urine protein and creatinine ratio. Methods The correlation and the consistency of the 24-hour urinary protein （24 h UTP） and random urine albumin / creatinine ratio （UACR） were analyzed. 213 cases of patients with chronic kidney were recruited and divided into five groups according to random urine creatinine （Ucr）, ie, Group A： 35 cases with Ucr below 2 000 mmol/L; Group B： 33 cases with Ucr between 2 000 and 3 000 mmol/L; group C： 46 cases with Ucr between 3 000 and 7 000 mmol/L; group D： 58 cases with Ucr between 7 000 and 15 000 mmol/L; group E： 41 cases with Ucr up 15 000 mmol/L. UACR and 24 h UTP were measured in all cases. Correlation analysis and kappa test were done in each group. Results The UACR and 24 h TP were highly correlated and had strong consistency in Group B, C, D. The value of r and kappa values were： 0.836, 0.762 in Group B, 0.886,0.758 in group C, 0.868, 0.753 in Group D,respectively. However, lower relation and poor consittency between UACR and 24 h TP were found in group A and group E, with r and kappa values were： 0.632, 0.397 in Group A, 0.597, 0.454 group E. The r and kappa values in the all of groups B, C and D were 0.887 and 0.757. Conclusion UACR was credible in sample with Ucr between 2 000 and 15 000 mmol/L. UACR was not consistent with 24 h UTP when the urinary creatinine was out of this range.

关 键 词：尿蛋白 尿白蛋白 肌酐比值 24H尿蛋白定量 

分 类 号：R446.12[医药卫生—诊断学]