尿糖联合尿微量白蛋白检验在糖尿病早期肾损伤诊断中的临床价值

Clinical Value of Urine Sugar Combined with Microalbuminuria in Early Diagnosis of Diabetic Nephropathy

目的探究糖尿病早期肾损伤诊断中尿糖、尿微量白蛋白联合检验的临床价值。方法选取2018年1月-2020年12月我院收治的糖尿病患者300例,根据有无早期肾损伤分为单纯糖尿病组(n=220)和糖尿病早期肾损伤组(n=80)。另选取同期在我院接受健康体检的100例健康者作为对照组。观察三组的尿糖、尿微量白蛋白水平,同时比较尿糖、尿微量白蛋白联合检验和单一检验在糖尿病早期肾损伤诊断效能。结果300例糖尿病患者中共发生80例早期肾损伤,发生率为26.67%。经分析发现,尿糖和尿微量白蛋白联合检验在糖尿病早期肾损伤中的诊断符合率(99.00%)、敏感性(98.75%)、特异性(99.09%)高于尿糖检验(83.33%、56.25%、93.18%)和尿微量白蛋白检验(85.67%、63.75%、93.64%)(P<0.05)。尿糖方面:单纯糖尿病组、糖尿病早期肾损伤组的+~++++检出率高于对照组(P<0.05);同时,在+~++中,单纯糖尿病组的检出率高于糖尿病早期肾损伤组(P<0.05),而在+++~++++中,糖尿病早期肾损伤组检出率高于单纯糖尿病组(P<0.05)。尿微量白蛋白方面:单纯糖尿病组、糖尿病早期肾损伤组的尿微量白蛋白水平高于对照组(P<0.05),且糖尿病早期肾损伤组的尿微量白蛋白水平也高于单纯糖尿病组(P<0.05)。结论与健康人群相比,糖尿病患者的尿糖、尿微量白蛋白水平较高,而当发生糖尿病早期肾损伤,患者的尿糖、尿微量白蛋白水平会出现显著上升趋势,且进行尿糖、尿微量白蛋白联合检验,能进一步提高糖尿病早期肾损伤的诊断符合率、敏感性和特异性,临床诊断价值显著。

Objective To explore the clinical value of combined testing of urine glucose and urine microalbumin in the diagnosis of early renal injury in diabetes.Methods A total of 300 patients with diabetes admitted to our hospital from January 2018 to December 2020 were selected and divided into simple diabetes group(n=220)and early diabetic renal injury group(n=80)according to the presence or absence of early renal injury.Another 100 healthy people who received physical examination in our hospital during the same period were selected as the control group.The levels of urine glucose and urinary albumin in the three groups were observed,and the diagnostic efficacy of combined test and single test of urine glucose and urinary albumin in early renal injury of diabetes was compared.Results There were 80 cases of early renal injury in 300 diabetic patients,the incidence was 26.67%.After analysis,it was found that the diagnostic coincidence rate(99.00%),sensitivity(98.75%)and specificity(99.09%)of urine glucose and urine microalbumin combined test in early diabetic kidney injury were higher than those of urine glucose test(83.33%,56.25%,93.18%)and urine microalbumin test(85.67%,63.75%,93.64%)(P<0.05).In terms of urine glucose:the detection rate of+-++++in the simple diabetes group and early diabetic kidney injury group was significantly higher than that in the control group(P<0.05);at the same time,in the+-++,the detection rate of the simple diabetes group was higher than that in the early diabetic kidney injury group(P<0.05),and in+++-++++,the detection rate of early diabetic kidney injury was higher than that in the simple diabetes group(P<0.05).In terms of urine microalbumin:the urine microalbumin level of the simple diabetes group and the early diabetic kidney injury group was significantly higher than that of the control group(P<0.05),and the urine microalbumin level of the early diabetic kidney injury group was also significantly higher than that of simple diabetes group(P<0.05).Conclusion Compared with healthy people,diabetic patients have higher urine glucose and urine microalbumin levels.When the early renal injury of diabetes occurs,the levels of urine glucose and urine microalbumin in patients will show an aboriginal upward trend.The combined test of urine glucose and urine microalbumin can further improve the diagnostic coincidence rate,sensitivity and specificity of early renal injury of diabetes,and the clinical diagnostic value is aboriginal.