ACR半定量试纸条法对尿白蛋白尿的诊断评价

An Evaluation of ACR Semi-Quantitative Test Strip in the Diagnosis of Urinary Albuminuria

目的评价尿白蛋白/肌酐比值(ACR)半定量试纸条法对尿白蛋白尿的诊断价值。方法选择住院及门诊患者共1152例,留取晨尿标本,均同时进行全自动生化分析仪定量检测ACR,尿干化学分析仪半定量检测尿蛋白(PRO)、尿白蛋白(ALB)、尿肌酐(CRE)、尿蛋白/肌酐比值(PCR)以及ACR。分析半定量PRO、ALB、CRE、PCR、ACR与定量ACR的相关性,绘制受试者工作特征曲线(ROC),评价半定量试纸条法对尿白蛋白尿的诊断效能。结果半定量PRO、ALB、PCR、ACR与定量ACR之间均呈正相关,相关系数(r)分别为0.589、0.646、0.613和0.700,差异均有统计学意义(P<0.001),半定量ACR与定量ACR之间的相关性最强。半定量PRO、ALB、PCR、ACR的ROC曲线下面积(AUC)分别为0.811、0.865、0.790、0.876,差异均有统计学意义(P<0.001),半定量ACR诊断尿白蛋白尿的效能最好。结论ACR半定量试纸条法对尿白蛋白尿的检测具有良好的诊断效能,可作为临床实验室的一项有用的筛查手段。

Objective To evaluate the diagnostic value of urinary albumin/creatinine ratio(ACR)semi-quantitative test strip method in urinary albuminuria.Methods Morning urine samples were collected from 1152 inpatients and outpatients.ACR was quantitatively detected by automatic biochemical analyzer,and urinary protein(PRO),urinary albumin(ALB),urinary creatinine(CRE),urinary protein/creatinine ratio(PCR)and ACR were measured semi-quantitatively by urine dry chemical analyzer.The correlation between semi-quantitative PRO,ALB,CRE,PCR,ACR and quantitative ACR was analyzed.the receiver operating characteristic curves(ROCs)of these markers were drawn,and the diagnostic efficacy of semi-quantitative test strip method for urinary albuminuria was evaluated.Results There were positive correlations between semi-quantitative PRO,ALB,PCR,ACR and quantitative ACR,and the correlation coefficients(r)were 0.589,0.646,0.613 and 0.700,respectively,and the difference was statistically significant(P<0.001).Among them,the correlation between semi-quantitative ACR and quantitative ACR was the strongest.The area under ROC curve(AUC)of semi-quantitative PRO,ALB,PCR and ACR were 0.811,0.865,0.790 and 0.876,respectively,and the difference was statistically significant(P<0.001).Semi-quantitative ACR was the best index in the diagnosis of urinary albuminuria.Conclusion ACR semi-quantitative test strip method has a good diagnostic efficacy in the detection of urinary albuminuria,and can be used as a useful screening method in clinical laboratory.