·糖尿病性肾脏疾病·

　　常虹 孙倩倩 谈敏

　　基金项目：2009年安徽省卫生厅青年科研基金资助(09B131)

　　作者单位: 230001合肥，安徽省立医院干部病房干三病区

　　【摘要】 目的 探讨尿白蛋白与肌酐比值(UACR)和肾小球滤过率(GFR)联合诊断在糖尿病肾脏病变评估中的临床意义。 方法 分析294例住院糖尿病患者的资料，行99mTC-DTPA 肾小球滤过率和 UACR检查。 结果 正常白蛋白尿、微量白蛋白尿及大量白蛋白尿患者中分别有9.6%(15/157)、25.3%(23/91)、45.7%(21/46)出现了GFR的下降;以UACR为标准诊断糖尿病患者肾损害的灵敏度、特异度分别为88.9%、59.3%，以GFR为标准其灵敏度、特异度分别为80.6%、88.8%，而联合UACR与GFR诊断其灵敏度、特异度分别为94.4%、54.3%;  结论  UACR正常的糖尿病患者已有部分出现肾功能下降，联合GFR有助于更好地评价糖尿病患者的肾脏病变情况。

　　【关键词】糖尿病;尿白蛋白与肌酐比值;肾小球滤过率;慢性肾脏病变

　　doi:10.3969/j.issn.1006-6187.2011.10.006

　　The relationship between urinary albumin to creatinine ratio and glomerular filtration rate measured by 99mTC-DTPA renal scintigraphy in diabetic patients

　　CHANG Hong，SUM Qian-qian, TAN Min.

　　Department of Geriatric Medicine ,The Affiliated Provincial Hospital of Anhui Medical University ,Hefei 230001, China

　　【Abstract】 Objective To investigate the relationship between urinary albumin to creatinine ratio (UACR) and glomerular filtration rate (GFR) in diabetic chronic kidney disease.   Methods  A total of 294 diabetic patients were enrolled. The glomerular filtration rate was measured by 99mTC-DTPA renal scintigraphy. We measured urine albumin and creatinine, and calculated UACR and then analyzed the relation between UACR and GFR .   Results   (1) There were 59 patients who had low GFR[GFR<60 ml·min-1·(1.73m)-2]，including 15 patients (9.6%) with normoalbuminuria ,23 patients (25.3%) with microalbuminuria and 21 patients (45.7%) with macroalbuminuria. (2)The sensitivity and specificity in patients diagnosed as chronic kidney disease were 88.9% and 59.3% based on only UACR, were 94.4% and 54.3% based on combination of UACR and GFR, and were 81% and 89% based on only GFR, respectively.   Conclusion   A considerable proportion in diabetic patients without albuminuria may have renal impairment. The combination of UACR and GFR may enhance the capability of diagnosis

　　of chronic kidney disease.

　　【Key words】Diabetes mellitus; Glomerular filtration rate;Urine albumin to creatinine ratio; Chronic kidney disease