三种蛋白尿测定方法的相关性研究

Study about the correlation of three methods to measure the urinary protein

目的:通过观察慢性肾脏病患者晨尿尿蛋白/尿肌酐(Up/Ucr)和晨尿尿蛋白/尿渗透压(Up/Uosm)与24h尿蛋白定量(Pr24h)的相关性,探讨二者代替24h尿蛋白定量的可行性。方法:106例慢性肾脏病患者留取晨尿及24h尿,测定晨尿尿蛋白/尿肌酐和晨尿尿蛋白/尿渗透压比值及24h尿蛋白定量,根据肾小球滤过率(GFR)分5组,确定各组中两者与24h尿蛋白定量的相关性,根据ROC曲线确定二者分别对于24h尿蛋白定量≥1.0g、≥2.0g、≥3.0g的临界值。结果:Up/Ucr在GFR≥15ml/min时与Pr24h相关,GFR<15ml/min时无关。Up/Uosm在所有分组中均与Pr24h相关。二者分别对于Pr24h≥1.0g、≥2.0g、≥3.0g的临界值为0.98、1.96、2.98及0.96、1.99、2.95。结论:Up/Ucr和Up/Uosm均可替代24h尿蛋白定量预测蛋白尿。

Objective： To determine spot urine protein/creatinine and protein/osmolality ratio can replace 24-hour urinary protein excretion or not as a good standard,through studying the correlation of them. Methods： All the ninty-threee paitents with chronic kidney disease are divided into five groups according glomerular filtration rate （GFR）,then evaluate the relationship between protein/creatinine and protein/osmolality ratio and 24-hour urinary protein in each group, finally,get the cutoff values of protein/creatinine and protein/osmolality ratio to 24-hour urinary protein （≥ 1.0g, ≥2.0g,≥3.0g,） by receiver operating characteristics （ROC）curve. Result： When the GFR ≥ 15ml/min,Up/Ucr is greatly correlated to Pr24h,however ,whatever the GFR is, Up/Uosm and Pr24h are stilly relative.By ROC curve analysis,the Up/Ucr of 0.98 g/g, 1.96 g/g and 2.98g/g represented the threshold to detect Pr24h of ≥ 1.0g,/〉 2.0g and ≥ 3.0g,respectively. Ditto, the protein/osmolality is 0.96g/Osmol, 1.99 g/Osmol and2.95 g/Osmol. Conclusion： The Up/Ucr can be used as an alternative tourine protein excretion in 24h Upcollections in paitents with GFR ≥ 15ml/min, howevwr, the Up/Uosm can be used in every paitcnt,whatever the GFR is.