床旁检验半定量尿液清蛋白、肌酐及尿液清蛋白/肌酐比值对糖尿病肾病的早期筛查分析

Early Screening Analysis of Diabetic Nephropathy by Semi-quantitative Urine Albumin,Creatinine and Urine Albumin/Creatinine Ratio in Bed⁃side Tests

目的 分析半定量尿液清蛋白(Albumin, ALB)、肌酐(Creatinine, Cr)及ALB/Cr比值(Albumin Creatinine Ratio, ACR)、尿糖(Urine Glucose, UGLU)对糖尿病肾病(Diabetic Nephropathy, DN)的早期筛查效果。方法 选取2019年4月—2022年12月泉州医学高等专科学校附属人民医院收治的70例DN患者为A组,另选取同期50例健康体检者为B组,分析两组ALB、Cr、ACR、UGLU水平及半定量测定ALB、Cr、ACR、UGLU的价值。结果 A组ALB、Cr、ACR、UGLU水平均高于B组,差异有统计学意义(P均<0.05)。半定量测定ACR灵敏度94.29%(66/70)、特异度92.00%(46/50)、准确度93.33%(112/120)、阳性预测值94.29%(66/70)、阴性预测值92.00%(46/50);Cr灵敏度84.29%(59/70)、特异度84.00%(42/50)、准确度84.17%(101/120)、阳性预测值88.06%(59/67)、阴性预测值79.25%(42/53);ALB灵敏度80.00%(56/70)、特异度76.00%(38/50)、准确度78.33%(94/120)、阳性预测值82.35%(56/68)、阴性预测值73.08%(38/52);UGLU灵敏度85.71%(60/70)、特异度80.00%(40/50)、准确度83.33%(100/120)、阳性预测值85.71%(60/70)、阴性预测值80.00%(40/50)。结论 ALB、Cr、ACR、UGLU在早期DN患者中有较高的诊断价值,且半定量ACR对早期DN诊断符合率较高,可为今后研究提供理论性支撑。

Objective To analyze the early screening effect of semi quantitative urinary albumin(ALB),creatinine(Cr),ALB/Cr ratio(ACR)and urine glucose(UGLU)on diabetes nephropathy(DN).Methods Seventy cases of DN pa-tients admitted to the People's Hospital Affiliated to Quanzhou Medical College from April 2019 to December 2022 were selected as group A,and 50 healthy physical examination cases during the same period were selected as group B,and the levels of ALB,Cr,ACR and UGLU of the two groups were analyzed,and the value of semi-quantitative deter-mination of ALB,Cr,ACR and UGLU was analyzed.Results The levels of ALB,Cr,ACR and UGLU in group A were higher than those in group B,and the differences were statistically significant(all P<0.05).The sensitivity of ACR was was 94.29%(66/70),the specificity was 92.00%(46/50),the accuracy was 93.33%(112/120),the positive predictive value 94.29%(66/70)and the negative predictive value was 92.00%(46/50).The sensitivity of Cr was 84.29%(59/70),specificity was 84.00%(42/50),accuracy was 84.17%(101/120),positive predictive value was 88.06%(59/67),negative predictive value was 79.25%(42/53);The sensitivity of ALB was 80.00%(56/70),specificity was 76.00%(38/50),accuracy was 78.33%(94/120),positive predictive value was 82.35%(56/68),negative predictive value was 73.08%(38/52).The sensitivity of UGLU was 85.71%(60/70),specificity was 80.00%(40/50),accuracy was 83.33%(100/120),positive predictive value was 85.71%(60/70),negative predictive value 80.00%(40/50).Conclusion ALB,Cr,ACR,UGLU have high diagnostic value in patients with early DN,and semi-quantitative ACR has a high coinci-dence rate in the diagnosis of early DN,which can provide theoretical support for future research.