随机尿微量白蛋白检测对筛检早期糖尿病肾病的价值

The value of Random Urine Specimen Albumin Measurement in the Screening of Early Diabetic Nephropathy

评价随机尿白蛋白浓度检测对筛选糖尿病微量白蛋白尿的效能。 198例 2型糖尿病患者纳入研究 ,完成其 2 4h尿样收集及白天随机尿收集。白蛋白测定采用免疫比浊法。根据 2 4h尿白蛋白排泄率 (2 4hUAER)分为正常白蛋白尿组 (2 4hUAER <2 0 μg/min ,10 2例 )及微量白蛋白尿组 (2 4hUAER 2 0 - 2 0 0 μg/min ,96例 )两组。并绘制随机尿白蛋白浓度 (UAC)受试者工作曲线 (ROC)。结果是 :UAC与UAER相关 (r=0 .92 ,P <0 .0 0 1) ,UAC ROC10 0 %敏感度截断点UAC值为 15mg/L(特异度为 74 % ) ,敏感度与特异度最佳截断点UAC值为 30mg/L(敏感度90 % ,特异度 89% )。随机UAC对于筛选微量白蛋白尿准确性较高 ,且较UAER简便、经济 。

To assess the performance of measurements of urinary albumin concentration (UAC) in a diurnal random urine specimen (RUS) for the screening of diabetic nephropathy (DN), 24h urine specimen and diurnal random urine specimen in 198 patients with type 2 diabetes mellitus (male 102, female 96, age 40-65) were collected. Albumin was measured by immunoturbidimetry. According to 24h urinary albumin excretion rate (24h UAER), the specimens were classified as normoalbuminuria (24h UAER<20μg/min, n=102), microalbuminuria (24h UAER 20-200μg/min, n=96). The receiver operating characteristic (ROC) curve approach was used. The ROC curves of UAC in RUS for screening of microalbuminuria were plotted. Spearmans coefficient of correlation of 24h UAER vs UAC was 0.92 ( P <0.001). The first point with 100% sensitivity and the point of intersection with a 100% to 100% diagonal for microalbuminuria were as follows: 15mg/L(74% specificity) and 30mg/L (92% sensitivity and 89% specificity). Measurement of UAC in RUS presented almost perfect accuracy for the screening of microalbuminuria, and UAC measured in a RUS is simpler than 24h UAER, it is suggested as a valid test for screening of incipient diabetic nephropathy in clinical practice.