点尿法及24h尿收集法估算高血压病患者24h尿钠钾排泄量的应用比较  

Comparison of the spot urine and 24-hour urine collection method in evaluating 24-hour sodium and potassium excretion in patients with hypertension

作　　者：姜薇 张俊仕[1] 帕提古丽[1] 李清晨 徐新娟[1] Jiang Wei;Zhang Junshi;Patiguli;Li Qingchen;Xu Xinjuan(Department of Hypertension,the first Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院高血压科,乌鲁木齐830054

出　　处：《中华诊断学电子杂志》2019年第1期21-25,共5页Chinese Journal of Diagnostics(Electronic Edition)

摘　　要：目的探讨利用点尿法及24 h尿收集法估算高血压病患者24 h尿钠钾排泄量的应用价值。方法研究对象为2017年2月至2018年1月就诊于新疆医科大学第一附属医院高血压科的高血压病患者,共264例。收集患者24 h尿及相应的清晨空腹点尿,分别测定所有尿样的钠、钾、肌酐水平。采用Tanaka、Kawasaki和INTERSALT公式分别估算点尿法24 h尿钠钾排泄量,采用配对秩和检验比较公式估算值与实际测量值的差异;利用Spearman相关分析评价各公式估算的24 h尿钠钾排泄量与实测24 h尿钠钾排泄量的相关关系。结果 Tanaka法公式估算的24 h尿钠值(167. 99 mmol/d)高于实际24 h尿钠值(157. 73 mmol/d),差异无统计学意义(Z=-0. 23,P>0. 05); Kawasaki法公式估算的24 h尿钠值(217. 66 mmol/d)亦高于实际24 h尿钠值,差异有统计学意义(Z=-8. 81,P <0. 01);INTERSALT法公式估算的24 h尿钠值(154. 71 mmol/d)低于实际24 h尿钠值,差异有统计学意义(Z=-3. 53,P <0. 01)。Tanaka、Kawasaki和INTERSALT公式估算的24 h尿钠值与实际24 h尿钠值的相关系数分别为0. 68,0. 55,0. 58(均P <0. 01); Tanaka公式估算的24 h尿钾值(39. 51 mmol/d)低于实际测量值(42. 90 mmol/d),差异有统计学意义(Z=-3. 47,P <0. 05),相关系数为0. 50(P <0. 01)。结论在高血压病患者中,公式法估算的24 h尿钠钾排泄量与实际测量值,存在不同程度的低估与高估,且相关性差。利用点尿法公式估算高血压病患者24 h尿钠钾排泄量存在一定程度的不准确性和局限性。Objective To compare spot urine and 24 hour urine collection method in evaluating 24 hour sodium and potassium excretion in patients with hypertension.Methods From February 2017 to January 2018,264 patients with hypertension in hypertension department of the First Affiliated Hospital of Xinjiang Medical University were enrolled in the study.24 hour urine specimens and morning fasting spot urine specimens were collected for detecting urinary sodium,potassium and creatinine levels.The Tanaka,Kawasaki and INTERSALT formulas were used to estimate the 24 hour urinary sodium and potassium excretion.The paired rank sum test was used to compare the difference between the estimated value and the actual measured value.Spearman correlation was used to evaluate the relationship between the estimated value and the actual value of 24 h urinary sodium and potassium excretion.Results The 24 hour urinary sodium value estimated by Tanaka formula(167.99 mmol/d)was higher than that estimated by actual 24 hour urinary sodium value(157.73 mmol/d),with no significant difference(Z=-0.23,P>0.05).The 24 hour urinary sodium value estimated by Kawasaki formula(217.66 mmol/d)was also higher than that estimated by actual 24 hour urinary sodium value,with significant difference(t=-8.81,P<0.05).The 24 hour urinary sodium value estimated by INTERSALT formula(154.71 mmol/d)was lower than the actual 24 hour urinary sodium value,and the difference was statistically significant(Z=-3.53,P<0.01).The correlation coefficients between the estimated values of Tanaka,Kawasaki and INTERSALT formulas and the actual 24 h urine sodium value were 0.68,0.55,0.58,respectively,(all P<0.01).Tanaka formula estimated potassium excretion value(39.51 mmol/d)was lower than the actual measured value(42.90 mmol/d),the difference was statistically significant(Z=-3.47,P<0.05),the correlation coefficient was 0.50,(P<0.01).Conclusions In hypertensive patients,the 24 h urinary sodium excretion and urinary potassium estimated by formulas is underestimated or overestimated in va

关 键 词：高血压 24小时尿收集 点尿 尿钠排泄量 尿钾排泄量 

分 类 号：R544.1[医药卫生—心血管疾病]