中国实验诊断学

目的探讨尿微量白蛋白/肌酐比值在糖尿病肾病早期诊断中的价值。方法选取确诊为2型糖尿病患者293例和体检健康体检者70例,对其尿微量白蛋白/肌酐比值(晨起空腹及随机)、24小时尿微量白蛋白定量、尿微量白蛋白排泄率、尿素氮、血肌酐、尿常规等临床资料进行回顾性分析,观察上述不同检测方法对糖尿病早期诊断灵敏度。结果晨起、随机尿微量白蛋白/肌酐值与尿微量白蛋白排泄率(urine albumin excretion rateUAER)、24h尿微量白蛋白定量成显著正相关,晨起空腹尿ACR与UAER、24小时尿微量白蛋白定量的相关系数分别为r=0.936(P<0.01),r=0.906,(P<0.01);随机尿ACR与UAER和24h尿微量白蛋白相关系数分别为r=0.756(P<0.01),r=0.738,(P<0.01)。2型糖尿病组尿ACR阳性组和阴性组之间比较尿蛋白、血肌酐、尿素氮水平无统计学差异,P>0.05。将血肌酐、尿素氮、尿ACR诊断糖尿病肾病敏感性比较,尿ACR阳性率显著高于前两者,P<0.01。结论晨起空腹及随机尿微量白蛋白/肌酐比值两者均可以作为糖尿病肾病早期诊断的敏感指标。

Objective To investigate the value of the urinary albumin creatinine ratio in the early diagnosis of diabetic kidney disease.Methods According to the diagnostic criteria of type 2diabetes,collection of 293cases of type 2diabetes patients.And selectting healthy physical examination of 70cases as control group group.For the clinical date of microalbumin creatinine ratio,24hurine albumin quantitatively,urine albumin excretion rate,serum creatinine,blood urea nitrogen and urine routine test were retrospectively analyzed.Observed above the value of different detection methods for the early diagnosis of diabetic nephropathy.Results Morning fasting urine microalbumin/creatinine and urinary albumin excretion rate,24hurinary micro albumin determination into a significant positive correlation.Morning fasting urinary ACR with UAER,24-hour urine trace albumin quantitative correlation coefficient of r=0.936(P<0.01),r= 0.906,(P<0.01).Random urine microalbumin/creatinine and urinary albumin excretion rate,24hurinary micro albumin determination into a significant positive correlation.Random urinary ACR with UAER,24-hour urine trace albumin quantitative correlation coefficient of r=0.756(P<0.01),r=0.738,(P<0.01).Type 2diabetes urinary ACR in the positive group and negative group comparison between urinary protein,serum creatinine,blood urea nitrogen level,no statistical difference(P>0.05).Serum creatinine,blood urea nitrogen,urinary ACR in the diagnosis of diabetic nephropathy sensitivity comparison,urinary ACR positive rate was significantly higher than the previous two,P<0.01).Conclusion Morning fasting and random urine albumin/creatinine ratio,both can be used as sensitive indicators of early diagnosis of diabetic nephropathy.