尿微量白蛋白/尿肌酐比值在老年充血性心力衰竭中的变化及临床价值探讨  

Changes and clinical value of urinary microalbumin/creatinine ratio in elderly patients with congestive heart failure

作　　者：钱鹏[1] 曹选超[1] 徐先静[1] 王心慧[1] 段明勤[1] 黄改荣[1] QIAN Peng;CAO Xuan-chao;XU Xian-jing;WANG Xin-hui;DUAN Ming-qin;HUANG Gai-rang(Department of Geriatric Medicine,Henan Provincial People's Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]河南省人民医院老年医学科,河南郑州450003

出　　处：《中国卫生检验杂志》2020年第18期2177-2179,共3页Chinese Journal of Health Laboratory Technology

基　　金：2016年河南省医学科技攻关计划项目(201602226)。

摘　　要：目的探究尿微量白蛋白/尿肌酐比值在老年充血性心力衰竭中的变化及临床价值。方法回顾分析本院2019年1月-2020年1月收治的90例老年充血性心力衰竭患者的临床资料,并选取同期健康体检志愿者30例作为正常对照。收集患者尿微量白蛋白/尿肌酐比值(UACR)、血清N末端B型利钠肽原(NT-pro BNP)、肿瘤坏死因子-α(TNF-α)及血尿酸(SUA)水平进行比较分析,并分析UACR与左心室舒张末期内径(LVEDD)及左心室射血分数(LVEF)的相关性及其诊断价值。结果不同NYHA心功能分级患者UACR、血清NT-pro BNP、TNF-α及SUA水平存在显著差异,差异有统计学意义(P<0.05)。UACR值与NT-pro BNP、TNF-α、SUA、LVEDD均呈正相关(r值分别为0.403、0.375、0.415、0.403,均P<0.001),与LVEF呈负相关(r=-0.208,P<0.001)。ROC曲线分析URCA诊断老年充血性心力衰竭的AUC为0.736,灵敏度为75.65%。结论老年充血性心力衰竭患者URCA值明显升高,并随病情加重而不断升高,URCA对充血性心力衰竭具有显著诊断价值。Objective To explore the changes and clinical value of urine microalbumin/urinary creatinine ratio in elderly patients with congestive heart failure.Methods The clinical data of 90 elderly patients with congestive heart failure admitted to our hospital from January 2019 to January 2020 were retrospectively analyzed,and 30 healthy volunteers were selected as normal controls during the same period.The urine microalbumin/urinary creatinine ratio(UACR),serum N-terminal pro-B-type natriuretic peptide(NT-pro BNP),tumor necrosis factor-α(TNF-α)and blood uric acid(SUA)levels were collected for comparative analysis;and the correlation between UACR and left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)and its diagnostic value were analyzed.Results There was statistical significance on the differences in UACR,serum NT-prob NP,TNF-αand SUA levels in patients with different NYHA cardiac function grades,with the differences statistically significant(P<0.05).It’s showed that UACR was positively correlated with NT-pro BNP,TNF-α,SUA,and LVEDD(r=0.403,r=0.375,r=0.415,r=0.403,P<0.001),and negatively correlated with LVEF(r=-0.208,P<0.001).ROC curve analysis showed that the AUC of URCA in diagnosing congestive heart failure in the elderly was 0.736 and the sensitivity was 75.65%.Conclusion The URCA value of elderly patients with congestive heart failure is significantly increased,and it continues to increase with the aggravation of the condition.URCA has a significant diagnostic value for congestive heart failure.

关 键 词：尿微量白蛋白/尿肌酐比值 心力衰竭 心功能 临床诊断价值 

分 类 号：R541.6[医药卫生—心血管疾病]