慢性肾脏病患者基于24 h尿蛋白的尿蛋白肌酐比值估算方程研究  

Estimation equation of ratio of urine protein/creatinine based on 24-hour urine protein in patients with chronic kidney disease

作　　者：史德宝[1] 王健[1] 段敏 潘亚萍[1] 王中新[1] 徐元宏[1] 吕礼应[1] SHI Debao;WANG Jian;DUAN Min;PAN Yaping;WANG Zhongxin;XU Yuanhong;LU Liying(Department of Laboratory Medicine,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui,China)

机构地区：[1]安徽医科大学第一附属医院检验科,合肥230022

出　　处：《临床检验杂志》2022年第7期516-520,共5页Chinese Journal of Clinical Laboratory Science

摘　　要：目的分析慢性肾脏病(CKD)患者24 h尿蛋白(24huP)与尿蛋白肌酐比值(uPCR)的相关性,并基于不同拟合方法建立简单有效的估算方程。方法收集2018年1月至2020年12月我院肾内科住院且病因诊断明确的CKD患者636例,按性别、年龄、CKD分期等条件分组,比较各分组条件下24huP与uPCR的相关性;利用简单线性回归、多元线性回归、变量自然对数(ln)转换后线性回归,比较不同回归方式下相关性并建立估算方程。结果相关性分析显示,CKD1~4期,各分期24huP与uPCR相关性差异小(r为0.859~0.878,P均<0.05),CKD5期二者相关性(r=0.782,P<0.05)明显较CKD1~4降低;尿肌酐(uCr)分组显示,随着uCr水平升高,二者相关性升高;病因分组中,原发性肾病、多囊病uPCR与24huP相关性(r=0.845、0.856,P<0.05)相似,但均低于继发性肾病(r=0.961,P<0.05)。将24huP作为因变量,uPCR作为自变量,进行简单线性回归,相关系数为0.735(F=7441,P<0.001);将24huP作为因变量,性别、年龄、胆固醇等作为自变量进行多元线性回归,相关系数为0.858(F=135.657,P<0.001);将uPCR及24huP数据经ln转换后,以ln(24huP)为因变量(Y),ln(uPCR)为自变量(X)进行线性回归,Y=1.729+0.783X(r=0.863,F=1871.168,P<0.001)。结论uPCR与24huP相关性较好,但应注意uCr低值或高值时,uPCR可能会高估或低估24huP;基于变量ln转换后线性回归,建立了简单有效的24huP与uPCR的估算方程。Objective To analyze the correlation between 24-hour urine protein(24 huP)and urine protein creatinine ratio(uPCR)in the patients with chronic kidney disease(CKD),and establish a simple and effective estimation equation based on different fitting methods.Methods A total of 636 patients with CKD who were admitted to the Department of Nephrology in our hospital from January 2008 to December 2020 with definite etiological diagnosis were collected.They were divided into different groups according to gender,age,stage of CKD,etc.The correlations between 24 huP and uPCR were compared under each group condition.By using simple linear regression,multiple linear regression and linear regression after natural logarithm(ln)conversion,the correlation differences under different regression methods were compared and the estimation equation was established.Results The correlation analysis showed that there were little differences between 24 huP and uPCR in CKD1 to 4 stage(r=0.859 to 0.878,all P<0.05),and the correlation between 24 huP and uPCR in CKD5-stage was significantly lower than that in CKD1-4 stage(r=0.782,P<0.05).The correlation between the two groups was increased with the level of urine creatinine.In the etiological group,the uPCR correlation of 24 huP between primary nephropathy and polycystic disease was similar,but lower than that of secondary nephropathy(r=0.845,0.856,all P<0.05).Using 24 huP as the dependent variable and uPCR as the independent variable,the correlation coefficient was 0.735(F=7441,P<0.001)with simple linear regression.Multiple linear regression was performed with 24 huP as dependent variable and gender,age,cholesterol,etc as independent variables,and the correlation coefficient was 0.858(F=135.657,P<0.001).After the uPCR and 24 huP data were converted by ln,the linear regression was conducted with ln(24 huP)as the dependent variable(Y)and ln(uPCR)as the independent variable(X)by the formula Y=1.729+0.783X(r=0.863,F=1871.168,P<0.001).Conclusion uPCR showed good correlation with 24 huP,but it shoul

关 键 词：24小时尿蛋白 尿蛋白肌酐比值 慢性肾脏病 

分 类 号：R446[医药卫生—诊断学]