老年人群中第二次和第一次晨尿清蛋白检测的比较

Results comparison between the second and first morning voids on assess albuminuria in elderly population

目的探讨老年人群中第一次晨尿和第二次晨尿清蛋白（UAC）检测评价蛋白尿的一致性。方法 2013年4∽6月天津市东丽区军粮城镇军粮城医院对军粮城镇管辖范围内12个乡村60岁以上老年人191例,其中糖尿病和高血压患者分别占16.8%和56.0%,收集第一次与第二次晨尿,检测UAC浓度和尿肌酐,并计算UAC/肌酐比值（ACR）;分析比较第一次晨尿ACR（ACR1）或第一次晨尿UAC（UAC1）和第二次晨尿ACR（ACR2）或第二次晨尿UAC（UAC2）的相关性,评价两类标本诊断蛋白尿能力的一致性。结果蛋白尿总体发病率为23.6%,在糖尿病组和高血压组人群分别是28.1%和29.0%。ACR1与ACR2差异无统计学意义（P=0.271）,但UAC1与UAC2差异有统计学意义（P=0.001）。ACR1与ACR2相关性（r=0.901）高于UAC1与UAC2的相关性（r=0.797）,且在男性ACR中相关性最强（r=0.938）。ACR1与ACR2评判蛋白尿能力（k=0.815）较UAC1与UAC2（k=0.627）有良好的一致性,其中以男性组（k=0.900）和高血压组（k=0.850）的ACR1与ACR2一致性最好。结论ACR2评价蛋白尿的能力与ACR1很相近（优于UAC）,ACR2也可作为UAC常规检测的可靠标本类型。

Objective To explore whether urine albumin concentration （U＇AC） from the second morning urine has a good con- sistent with that from the first morning urine when evaluated albuminuria in Chinese old people. Methods A total of 191 elderly people （〉60 years old） from Junliangcheng community were recruited in this study,included 16.8% diabetic patients and 56.0% hypertensive patients. The first and second morning urine were collected from each participants, and detected the urinary albumin and creatinine of each urine sample, calculated the ratio of albumin and creatinine（ACR）. Analyzed the correlation between UAC and ACR between the first and second morning urine. Results 23. 6% participants were detected with albuminuria,the incidence rates of UAC in the diabetic patients and hypertensive patients were 28.1% and 29.0% respectively. ACR of the first morning union and the second morning union were closely correlated（r= 0. 901）, which was significant higher than the relationship of UAC （r=0. 797）, especially in male the correlation of ACR was high（r= 0. 938）. A good concordance of ACR category （normal or albuminuria） was found between ACR of first morning union and ACR of second morning union （k= 0. 815 in overall%in male or hypertension group were 0. 900 and 0. 850）. Conclusion ACR of second morning urine might be the alternative to ACR of first morning urine （better than UAC）for albuminuria detection in elderly population.