干化学法筛查尿液微量白蛋白的临床应用评价

The Application Evaluation of Dry Chemical Screening Test for Urine Microalbuminuria

目的评估尿液干化学法筛查微量白蛋白尿(microalbuminuria, MAU)的临床应用价值。方法利用尿干化学纸片法检测453例住院患者首次晨尿中的微量白蛋白(mALB),同时用全自动生化分析仪检测尿微量白蛋白/肌酐比值(urinary albumin to creatinine ratio,UACR),以UACR为标准,评价尿液干化学法筛查MAU的临床价值。结果 453例尿标本中干化学纸片法筛查出MAU337例,阳性率为74.39%,而UACR法测出MAU阳性例数83例,阳性率为18.32%;两种方法检测结果具有相关性,相关系数为0.324;以UACR结果为标准时,干化学纸片筛查法灵敏度为91.6%(76/83),特异度为29.5%(109/370);阳性预测值为22.6%(76/337),阴性预测值为94.0%(109/116)。结论尿液干化学法筛查微量白蛋白尿灵敏度较高,具有一定的筛查价值,但特异度较差。

Objective To evaluate the clinical application value of a kind of dry chemical microalbuminuria(MAU) screening test. Methods Eraly morning urine samples were collected from 453 hospitalised patients,mALB of all urine samples was detected by dry chemical paper disk method. And then,all the same samples' urinary albumin to creatinine ratio(UACR) were detected by fully automatic biochemical analyser. Evaluate the screening effect of the dry chemical disk method based on the result of UACR. Results Three hundred and thirty three positive samples out of 453 were detected,the positive expression rate was 74.39%. On the other hand,the positive expression rate of UACR was 18.32%. The results of the two methods are correlated with a correlation coefficient 0.324. Subjects to the result of UACR,the sensitivity and specificity of dry chemical disk method were 91.6%(76/83)and 29.5%(109/370)respectively. Conclusions In the research,the dry chemical paper disk method used for MAU screening with high sensitivity,has a certain screening value. But its specificity is poor.