晨尿蛋白/尿肌酐比和24h尿蛋白定量的相关性分析与临床评价

Correlation between the first morning urine protein-creatinine ratio and 24-hour urine protein excretion and its clinical value

目的探讨晨尿蛋白/尿肌酐比值可否替代24h尿蛋白定量,监测尿蛋白的排泄情况。方法选取住院肾脏病患者136例,共272例尿标本,将晨尿蛋白/尿肌酐与24h尿蛋白定量进行相关性分析;采用ROC曲线分析确定晨尿蛋白/尿肌酐比值相对于24h尿蛋白定量≥0.15g、≥1.00g和≥3.00g最佳诊断点。结果晨尿蛋白/尿肌酐比值与24h尿蛋白定量呈显著正相关(r=0.83;P<0.001);24h尿蛋白定量≥0.15g,≥1.00g和≥3.00g时,临床诊断敏感性和特异性最佳点分别为晨尿蛋白/尿肌酐比值≥0.20g/gcr,≥0.95g/gcr和≥2.92g/gcr。结论晨尿蛋白/尿肌酐比值可替代24h尿蛋白定量,监测肾脏病患者尿蛋白排泄情况。

Objective This paper aimed to evaluate the clinical application of total protein-to-creatinine ratio in the first morning urine specimens as a predictor of urine protein exeretion in 24-hour collections. Methods 136 specimens of 24-hour urine and 136 specimens of the first morning urine were collected from inpatients with renal diseases. The correlations between protein-to-creatinine ratio in the first morning urine specimens and urinary protien exeretion in 24-hour specimenss were analyzed. The cutoff values of protein-to-creatinine ratio in the first morning urine specimens for screening urinary protien excretion of over 0. 15 g, 1.00g and 3.00g in 24-hour specimens were determined by receiver operating characteristics （ROC） curve. Results There was a significant positive correlation between the urinary protien exeretion in 24-hour urine specimens and protein-to-creatinine ratio in the first morning urine specimens. For urine protein excretion in 24-hour urine at ≥0.15 g, ≥ 1.00 g and≥3.00 g, the corresponding most sensitive and specific prediction protein-to-creatinine ratio was ≥0.20 g/gcr, ≥0. 95 g/gcr, ≥2. 92 g/gcr respectively. Conclusion The protein-to-creatinine ratio in the first morning urine samples can be used as an alternative to urine protein excertion in 24-hour collections in patients with kidney diseases.