晨尿尿总蛋白肌酐比的临床诊断效能研究

Clinical diagnostic efficacy of total protein and creatinine ratio(TPCR)of morning urine

目的探讨晨尿总蛋白肌酐比(TPCR)与24 h尿总蛋白(24 h-TP)的相关性及影响因素,评价其临床诊断效能。方法收集2018年5-11月就诊于肾内科的212例肾脏病患者尿液标本,分别留取晨尿、随机尿、24 h尿标本进行TPCR、干化学试带法尿蛋白定性和24 h-TP定量测定,计算TPCR和24-TP的相关性,评价年龄、性别对其的影响;绘制ROC曲线评价TPCR值判断不同24 h-TP临界值的特异度和灵敏度。结果24 h-TP各组(≤0.2组、0.2~1.0组、1.0~3.0组、≥3.0组)的TPCR值分别为(0.15±0.23、0.46±0.36、1.48±1.19、3.19±1.93),各组之间差异均有统计学意义。不同年龄、性别和疾病类型24 h-TP和TPCR值相关性良好(r=0.859,P<0.01)。以24 h尿蛋白定量为3.0、1.0和0.2 g/24 h为诊断界点分别绘制ROC曲线,TPCR的cut off值分别为0.189、0.664、2.115(mg/mg)。结论TPCR与24 h-TP具有良好相关性,并不受年龄、性别的影响,TPCR可以用于肾病病情的监测。

Objective To explore the correlation between the ratio of total protein creatinine to ratio(TPCR)and 24-hour total protein(24 h-TP)in the morning urine and its influencing factors,and to evaluate its clinical diagnostic efficacy.Methods The urine samples of 212 patients with kidney disease from May 2018 to November 2018 were collected,including morning urine,random urine and 24 h urine samples and all of those samples above were done with TPCR,dry chemical test band method for qualitative determination of urine protein and 24 h-TP quantitative determination,calculated the correlation between TPCR and 24 h-TP and evaluated the influence of age and gender on it.Draw ROC curve to evaluate TPCR value,and judge the specificity and sensitivity of different 24 h-TP critical value.Results TPCR of groups(24 h-TP≤0.2,0.2-1.0,1.0-3.0,≥3.0)were(0.15±0.23,0.46±0.36,1.48±1.19,3.19±1.93),which have a statistically significant difference respectively.ROC curves were drawn with 24-h urine protein ration of 3.0,1.0 and 0.2 g/24 h as the diagnostic boundary points.The cut off values of TPCR were 0.189,0.664 and 2.115 mg/mg,respectively.Conclusion There may have a good correlation between TPCR of morning urine and 24 h-TP which is not affected by age and gender.TPCR can be used for nephropathy monitoring.