随机尿微量白蛋白/尿肌酐在早期糖尿病肾病患者筛查中的应用

Clinical application of urinary microalbumin/creatinine in random urine screening in patients with early diabetic nephropathy

目的通过对早期糖尿病肾病患者晨尿、餐后尿、随机尿等各时间段尿微量白蛋白(mAlb)和尿肌酐(Ucre)的检测,探讨随机尿mAlb/Ucre在早期糖尿病肾病患者筛查中的价值。方法选取安康市中医医院内分泌科2015年3月至2016年12月住院确诊为单纯糖尿病和早期糖尿病肾病患者98例,其中单纯糖尿病组47例,早期糖尿病肾病组51例;同时选取健康体检者60例作为对照组。分别检测其3 d晨尿、餐后尿、随机尿中mAlb和mAlb/Ucre求取平均值,对其进行比较分析。结果早期糖尿病肾病组mAlb浓度在晨尿、餐后尿、随机尿等不同时段中存在日间变化,晨尿[(60.5±27.1)mg/L]和餐后尿[(60.7±26.7)mg/L]接近且均高于随机尿[(40.9±25.1)mg/L],差异有统计学意义(F=9.551,P=0.000)。mAlb/Ucre在晨尿、餐后尿、随机尿等各时段尿中较为稳定,差异无统计学意义(P>0.05)。mAlb/Ucre检测的阳性率高于单一检测mAlb浓度的阳性率,随机尿中差别较为明显(mAlb的阳性率62.7%;mAlb/Ucre阳性率90.2%)。各组mAlb/Ucre检测的组间阳性率(晨尿92.2%,餐后尿88.2%,随机尿90.2%)差异无统计学意义(P>0.05)。结论各时段尿mAlb/Ucre的检测结果较为稳定,临床应用中优于单一mAlb检测,随机尿中mAlb/Ucre的检测以及阳性率均较高,便于在早期糖尿病肾病患者筛查中的应用。

Objective To determine the diagnosis value of urinary albumin(mAlb)/creatinine(Ucre)ratio in random urine from patients with early diabetic nephropathy.MethodsFrom March 2015 to December 2016,98 case with simple diabetes and early diabetic nephropathy in Ankang Hospital of Traditional Chinese Medicine were selected,including 47 cases with simple diabetes and 51 cases with early diabetic nephropathy.And 60 healthy people were selected as control group.The mAlb and mAlb/Ucre ratios in morning urine,postprandial urine and random urine were detected for three times in three days,and the resluts were calculated and analyzed.ResultsIn early diabetic nephropathy group,the mAlb concentration varied during different time periods,mAlb in morning urine[(60.5±27.1)mg/L]and postprandial urine[(60.7±26.7)mg/L]were significantly increased compared with that in random urine[(40.9±25.1)mg/L](F=9.551,P=0.000).The MAlb/Ucre ratios were stable in morning urine,postprandial urine and random urine of each period(P>0.05).The positive rate of mAlb/Ucre ratio was sharply higher than mAlb alone in random urine(90.2%vs.62.7%).No statistically significant difference showed in positive rates of mAlb/Ucre ratio in subjects from different groups(the positive rate of morning urine specimen was 92.2%;postprandial urine 88.2%;random urine 90.2%,P>0.05).ConclusionPositive rate of mAlb/Ucre ratio changed slightly during different test periods,and is superior to mAlb alone in clinic application.Additionally,the positive rate of mAlb/Ucre ratio in random urine could serve as an indicator in early screening of early diabetic nephropathy.