尿微量白蛋白与尿糖联合检测在早期糖尿病肾损伤中诊断意义

Diagnostic value of the combined detection of urine micro albumin and urine in early diabetic kidney injury

目的 探讨尿微量白蛋白与尿糖联合检测在早期糖尿病肾损伤中诊断意义。方法 选取2014年5月~2016年1月我院收治早期糖尿病患者300例为研究对象,采用单纯尿糖、单纯尿微量白蛋白和尿微量白蛋白联合尿糖对早期糖尿病肾损伤患者进行诊断,以病理结果为金标准,比较三种方法在早期糖尿病肾损伤中诊断灵敏度、特异性、阳性预测值及阴性预测值,同时以病理诊断为标准将患者分为A组（单纯糖尿病患者）和B组（早期糖尿病肾损伤患者）,比较两组患者尿微量白蛋白、尿糖水平及阳性率。结果 300例糖尿病患者经病理诊断为早期糖尿病肾损伤67例,发病率为22.33%。单纯尿微量白蛋白在早期肾损伤中诊断灵敏度为46.27%,特异度为95.28%,阳性预测值为73.81%,阴性预测值为86.05%。单纯尿糖检测在早期肾损伤中诊断灵敏度为56.72%,特异度为93.99%,阳性预测值为73.08%,阴性预测值为88.31%。尿微量白蛋白和尿糖联合检测早期肾损伤中诊断灵敏度为86.57%,特异度为91.42%,阳性预测值为74.36%,阴性预测值为91.42%。A组患者尿微量白蛋白和尿糖水平均低于B组[（15.4±5.4）mg/L vs（25.8±7.1）mg/L,（2.3±0.6）mmol/L vs（3.7±0.9）mmol/L,P〈0.05]。结论 尿微量白蛋白与尿糖联合检测在早期糖尿病肾病中诊断具有较高灵敏度和特异性,糖尿病早期肾损伤患者尿微量白蛋白和尿糖水平显著升高,可作为临床诊断早期糖尿病肾损伤有效指标。

Objective To explore diagnostic value of the combined detection of urine micro albumin and urine in early diabetic kidney injury. Methods 300 cases of early diabetic patients cured in our hospital form May 2014 to January 2016 were selected as the study objects. Simple urine, simple urinary micro albumin, urine micro albumin and urine were used to diagnose early diabetic renal injury. The gold standard was the result of pathology. Diagnostic sensitivity, specificity, positive predictive value and negative predictive value of the three methods in early diabetic kidney injury were compared. At the same time, the pathological diagnosis was used as the standard to divide the patients into group A （patients with simple diabetes mellitus） and group B （patients with early diabetic kidney injury）. Urinary micro albumin, urine sugar level and positive rate of the two groups were compared. Results Among the 300 cases of diabetic nephropathy, 67 cases were diagnosed as early diabetic renal injury, and the incidence rate was 22.33%.The diagnostic sensitivity of simple urinary micro albumin in early renal injury was 46.27%, the specificity was 95.28%,the positive predictive value was 73.81%,and the negative predictive value was 86.05%. The diagnosis sensitivity of simple urine detection in early kidney injury was 56.72%, the specificity was 93.99%,the positive predictive value was 73.08%, and the negative predictive value was 88.31%.The diagnostic sensitivity of urine micro albumin combined with urine detection of early renal damage was 86.57%, the specificity is 91.42%,the positive predictive value was 74.36%, and the negative predictive value was 91.42%.Urinary micro albumin and urine sugar level of group A were all lower than those of group B [（15.4 ±5.4） mg/L vs （25.8± 7.1） rag/L, （2.3± 0.6）mmol/L vs （3.7 ± 0.9）mmol/L,P 〈 0.05]. Conclusion The combined detection of urinary albumin and urine in the diagnosis of early diabetic nephropathy has high sensitivity and specificity. Urinary micro albumin and urine sugar level of patients with early diabetic renal injury were significantly increased. They can be used as effective indexes for early diabetic renal injury in clinical diagnosis.