尿蛋白/肌酐评估儿童IgA血管炎24 h尿蛋白定量的诊断效能  

Diagnostic efficacy of urinary protein/creatinine in quantification assessment of 24 h urinary protein in children with IgA vasculitis

作　　者：白梦刻 杨晓青[1] 李金刚[1] 梅晓峰[1] 黄岩杰[1,2] BAI Meng-ke;YANG Xiao-qing;LI Jin-gang;MEI Xiao-feng;HUANG Yan-jie(不详;Department of Pediatrics,the First Affiliated Hospital of Henan University of Chinese Medicine,Henan 450000,China)

机构地区：[1]河南中医药大学第一附属医院儿科,河南450000 [2]河南中医药大学第一临床医学院

出　　处：《中国卫生检验杂志》2023年第12期1409-1412,1429,共5页Chinese Journal of Health Laboratory Technology

基　　金：2021年度国家自然科学基金面上项目(82174187);河南省中医药学科领军人才项目(豫卫中医函[2021]8号);河南省特色骨干学科中医学学科建设项目(STG-ZYXKY-2020008)。

摘　　要：目的分析IgA血管炎(IgAV)患儿尿蛋白/肌酐(UPCR)评估24 h尿蛋白定量(24 h UP)的诊断效能及两者之间的相关性,并进一步分析出24 h UP为500 mg、1000 mg、2000 mg时UPCR对应的诊断界点。方法选取2018年1月—2022年6月在河南中医药大学第一附属医院儿科就诊的3岁~18岁IgAV患儿,共计1409例,其中学龄前(3岁~6岁)325例,学龄期(7岁~12岁)831例,青春期(13岁~18岁)253例。采用肌氨酸氧化酶法检测尿肌酐,邻苯三酚红钼法检测尿蛋白。通过Spearman分析各年龄段UPCR与24 h UP之间的相关性,运用Bland-Altman法验证UPCR与24 h UP之间的一致性。通过绘制ROC曲线分析UPCR评估24 h UP的诊断效能。结果IgAV患儿肾脏损伤发生率为25.83%。UPCR与24 h UP在各年龄段中成正相关,其中学龄前期(r=0.592)、学龄期(r=0.739)、青春期(r=0.787),P均<0.01。通过Bland-Altman分析各组中UPCP与24 h UP的95%一致性界限外的点占比均<5%。当UPCR>0.20 mg/mg、0.36 mg/mg、0.64 mg/mg、2.12 mg/mg时,评估24 h UP>150 mg、500 mg、1000 mg、2000 mg的AUC分别为0.947、0.977、0.982、0.993,P均<0.01。结论UPCR可有效替代24 h UP评估IgAV患儿尿蛋白水平,且随着年龄的增长,两者之间的相关性增加。Objective This paper aims to analyze the prognostic efficacy of urinary protein/creatinine(UPCR)in the quantifi⁃cation assessment of 24 h urinary protein(24 h UP)in children with IgA vasculitis(IgAV),and to further analyze the UPCR values when 24 h UP was respectively 500 mg,1000 mg and 2000 mg.Methods A total of 1409 children with IgAV aged 3 to 18 years were collected into this study,who were treated in the Pediatrics Department of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2018 to June 2022.Among them,325 were of preschool age(3-6 years old),831 were of school age(aged 7-12 years),and 253 were of adolescent age(aged 13-18 years).Urinary creati⁃nine was detected by creatine oxidase method and urinary protein by catechol red-molybdenum method.The correlation between UPCR and 24 h UP among different age groups was analyzed by Spearman analysis,and the agreement between UPCR and 24 h UP was verified using the Bland-Altman method.Evaluation efficacy of UPCR in assessing 24 h UP was analyzed by plotting ROC curves.Results The incidence of renal injury in children with IgAV was 25.83%.UPCR was positively associ⁃ated with 24 h UP in all age groups,including preschool age(r=0.592),school age(r=0.739),and adolescence(r=0.787)(P<0.01).Bland-Altman analysis showed that the proportions of agreement rate beyond 95%of UPCP and 24 h UP in all the groups were less than 5%.When UPCR was 0.2 mg/mg,0.36 mg/mg,0.64 mg/mg,2.12 mg/mg,the AUC for 24 h UP>150 mg,500 mg,1000 mg,2000 mg were 0.947,0.977,0.982,and 0.993,respectively(P<0.01).Conclu⁃sion The UPCR can effectively replace the 24 h UP to assess the urinary protein levels in children with IgAV,and the correla⁃tion increases with age.

关 键 词：IgA血管炎 尿蛋白/肌酐 24 h尿蛋白定量 

分 类 号：R446[医药卫生—诊断学]