尿蛋白试纸条定性与尿清蛋白/肌酐比值的相关性分析

Correlation between dipstick test for proteinuria and urine albumin-creatinine ratio

目的对尿蛋白试纸条定性与尿清蛋白/肌酐比值(ACR)的关系进行分析,为尿蛋白试纸条定性的结果解读提供依据。方法入选2011年10月至2013年10月在北京大学第一医院心内科及神经内科住院,同时检测了尿蛋白试纸条定性和ACR的946例冠心病或缺血性脑卒中患者。尿蛋白试纸条定性采用基于溴酚蓝反应的自动干化学法。尿清蛋白浓度采用免疫比浊法检测。尿肌酐浓度采用碱性苦味酸动力学法测定。用Spearman检验分析两者的相关性。以ACR≥30 mg/g作为蛋白尿的诊断标准,评估尿蛋白试纸条定性分析对于蛋白尿诊断的特异性和敏感性。结果尿蛋白试纸条定性与ACR之间呈正相关,相关系数为0.658,P<0.01。尿蛋白试纸条阴性的患者88.5%为正常蛋白尿(ACR<30 mg/g)。尿蛋白试纸条微量的患者61.2%为正常蛋白尿,而38.8%为轻度或重度蛋白尿(ACR≥30 mg/g)。尿蛋白试纸条1+的患者87.1%为轻度或重度蛋白尿。尿蛋白试纸条≥2+的患者99.2%为轻度和重度蛋白尿。结论尿蛋白试纸条定性存在假阴性和假阳性,应结合临床进行尿蛋白定量检测。

Objective To interpret the qualitative result of dipstick test for proteinuria on the basis of the corresponding correlations between dipstick test and urine albumin-creatinine ratio（ ACR）. Methods A total of 946 patients with coronary heart disease or ischemic stroke who were tested by both dipstick and ACR were enrolled from October 2011 to October 2013 in the Department of Cardiology and Neurology,Peking University First Hospital. Dipstick for proteinuria was tested by bromophenol blue assay and ACR was determined by immunoturbidimetric method / alkaline picric acid method,respectively. Spearman test was used to investigate the correlation between dipstick test and ACR. The criterion of albuminuriawas defined as ACR≥30 mg / g. The specificity and sensitivity of dipstick test for the diagnosis of albuminuria were evaluated. Results A positive correlation between dipstick test and ACR with correlation coefficient 0. 658 was found（ P〈0. 01）. In the patients with negative proteinuria tested by dipstick 88. 5 percent were confirmed as normal albuminuria. In the patients with trace proteinuria tested by dipstick 61. 2 percent were conformed as normal albuminuria,while 38. 8 percent of them were confirmed as mild or heavy albuminuria. In the patients with albuminuria 1 ＋ and ≥2 ＋ tested by dipstick 87. 1% and 99. 2% were confirmed as mild or heavy albuminuria respectively. Conclusion The results of dipstick test for proteinuria may be false negative or false positive. The quantitative determination of urine protein should be applied for clinical diagnosis.