微量白蛋白尿不同测定方法的比较

Comparison of Different Methods for Measurement of Microalbuminuria

目的:比较三种不同检测方法及不同标本留取方法对结果的影响,评价其作为临床诊断的准确性和实用性。方法:随机选取30例住院糖尿病(DM)患者用同份晨尿标本分别用免疫法半定量试纸条(STP)、免疫比浊法(ITM)及白蛋白/肌酐测定和放射免疫分析法(RIA)测定尿白蛋白浓度,并与24h尿白蛋白定量结果比较。结果:不同检测方法Pearson相关分析, P值均＜0．01,与24h尿白蛋白定量组比较,STP最低r=0．448;ITM ACR最高r=0．861。配对T检验ITM与RIA两组间;ITM ACR与24h尿白蛋白排泄量比较差异无显著性(P＞0．05)。与24h尿白蛋白定量列联表比较,ITM ACR测定的符合率B2．8%、敏感性80%、特异性85．7%(P=0．001),优于RIA晨尿测定。结论:几种尿白蛋白测定方法均有较好相关性,可用于临床检测。STP敏感度较高,但特异性差,适用于筛查。ITM与RIA结果比较差异无显著性,经肌酐校正的ACR与24h尿白蛋白定量结果相关性最好,且标本留取方便,更适于临床使用。

Objective： To evaluate the clinical utility and accuracy among three assays of Micral - Test strip, DCA 2000 analyzer and radioimmunoassay for detection of microalbuminuria and compare effect of urine collection ways on the results.Methods： A total of 30 random urine samples of patients with diabetes were determined by three assays for detection of microalbuminuria and the results were compared with 24- hour urinary albumin（24h UAL） .Results： The values determined by the three assays were correlative（P 〈 0.01） . Compared with the values of 24 - hour urinary albumin, the correlated coefficient of Mieral - Test strip and DCA2000 ＋ ACR was 0.448, 0. 861 respectively. There was no significant difference between the values of DCA2000 ＋ ACR and 24 - hour uriuary albumin （ P 〉 0.05）. Compared with the assay of 24 - hour urinary albumin, the diagnosis accordance rate, sensitivity and specificity of DCA2000 ＋ ACR were 82.8% , 80 %, 85.7% respectively （P = 0.001 ）. Conclusion： All of the above assays for urinary albumin detection were significantly correlated and can be used in clinical test. The method of Mieral - Test strip which had relative higher sensitivity and relative lower specificity is convenient for screening. There was no significant difference between DCA2000 ＋ ACR and radioimmunoassay. The assay of DCA2000 ＋ ACR corrected by ereatinine can be first chosen in clinical test for the best correlation with 24- hour urinary albumin and its convenience.