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3种尿蛋白检测方法对糖尿病性肾脏疾病诊断敏感性和特异性的比较

来自:中国糖尿病资讯网  编辑:lj|点击数:|2011-10-20

  3种尿蛋白检测方法对糖尿病性肾脏疾病诊断敏感性和特异性的比较

  宋新荣 陈莉明 常宝成 单春艳 郑妙艳 单秋妹

  ·糖尿病性肾脏疾病·

  作者单位:300070天津医科大学代谢病医院肾病科、卫生部及天

  津市激素与发育重点实验室

  通讯作者:陈莉明,E-mail :xfx22081@vip.163.com

  【摘要】 目的 比较尿蛋白的3种评价 方法 对于糖尿病性肾脏疾病(DKD)临床诊断的敏感性和特

  异性。 方法 对349例2型糖尿病患者进行24小时尿总蛋白(UTP)、尿白蛋白排泄率(UAER)、尿白蛋白/肌酐比值(ACR)测定及眼底检查,行工作特征曲线(ROC)分析,并观察3种 方法 与视网膜病变(DR)的相关性。 结果 ACR的ROC曲线下面积(AUC)是0.71,大于UAER的0.61和UTP的0.61(P<0.01),ACR诊断DKD的敏感性是68.42%(男)、60.0%(女),特异性是71.7%(男)、73.73%(女),均高于UTP和UAER。ROC曲线得出的UAER最佳临界点是54.95 μg/min。ACR-DR相关系数r为0.43,高于UTP-DR、UAER-DR 的相关系数。 结论 初步研究显示ACR对于DKD诊断的准确性高于UTP和UAER,且ACR的敏感性和特异性高。

  doi:10.3969/j.issn.1006-6187.2011.06.006

  Comparison of diagnostic sensitivity and specificity for diabetic kidney disease among different assays of urinary protein

  SONG Xin-rong,CHEN Li-ming,CHANG Bao-cheng.Hospital of Metabolic

  Diseases,Tianjin Medical University,Tianjin 300070,China

  Corresponding author:CHEN Li-ming,E-mail:xfx22081@vip.163.com

  【Abstract】 Objective To compare diagnostic sensitivity and specificity for diabetic kidney disease (DKD)among different urinary protein screening Methods. Methods 24-hour urinary total protein(UTP),urinary albumin excretion rate (UAER),urinary albumin/creatinine ratio (ACR)measurement and ocular fundus examination were performed in 349 patients with type 2 diabetes.The DKD diagnostic sensitivity and specificity of UTP,UAER and ACR were compared by receiver operating characteristic (ROC)curve analysis,and the correlation of the three Methods with retinopathy (DR)were investigated. Results The area under the ROC curve (AUC)was higher in ACR (0.71) than in UAER (0.61) or UTP (0.61)(all P<0.01).ACR had higher diagnostic sensitivity (68.42% in male and 60.0% in female)and higher specificity (71.7% in male and 73.73% in female)than UTP and UAER,respectively.The UAER optimal cut point derived from ROC curve was 54.95 μg/min.The correlation coefficient was r=0.43 between ACR and DKD and r=0.24 between UAER or UTP and DKD. Conclusions ACR may be superior to UTP and UAER in diagnosis of DKD.

  【Key words】Diabetic kidney disease;Diabetic retinopathy;Urinary albumin excretion rate;Urinary albumin/creatinine ratio

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