随机尿清蛋白/尿肌酐比率测定在慢性肾病的应用

目的研究随机尿清蛋白/尿肌酐比率测定在慢性肾病的应用。方法以测定24 h尿蛋白定量为金标准,比较56例蛋白尿阳性慢性肾脏疾病患者和33例蛋白尿阴性非慢性肾脏病患者的尿蛋白定性、随机尿蛋白定量、随机尿清蛋白定量、随机尿蛋白/肌酐比率、随机尿清蛋白/肌酐比率的检测结果,评价尿清蛋白/肌酐比率的灵敏度（S）、特异度（Sp）、似然比（LR）等诊断性能。结果与24 h尿蛋白定量结果比较：随机尿蛋白/肌酐比率,S=0.91、Sp=0.91、阴性预测值（NPV）=0.86、阳性预测值（PPV）=0.94、-LR=0.1、＋LR=10.1、准确性（ACC）=0.91;随机尿清蛋白/肌酐比率,S=0.96、Sp=0.88、NPV=0.94、PPV=0.93、-LR=0.045、＋LR=8.0、ACC=0.93。结论随机尿（清）蛋白/肌酐比率测定可作为筛检24 h尿蛋白定量的常规检测项目。

The role of the ratio of the random urinary(micro) albumin to the creactinine for diagnose chronic kidney diseases

Objective To study the role of the ratio of the random urinary（micro） albumin to the creatinine for diagnose chronic kidney diseases.Methods The results of the random urinary protein dipstick,the random urinary protein,the random urinary（micro） albumin,the random urinary protein/creatinine radio and the random urinary（micro） albumin/creatinine ratio were compared with the 24 h urine protein assay,the gold standard method,for diagnosis of proteinuria in 56 patients with chronic kidney diseases and in 34 patients without chronic kidney diseases but with high risk of being the diseases.And the diagnostic sensitivity（S）,specificity（Sp）,likelihood ratio（LR） and the other diagnostic performances of the tests above-mentioned were calculated and assessed.Results Compared with the test results of 24 h urinary protein,the diagnostic performances were as follows：for the random urinary protein/creatinine ratio,S=0.91,Sp=0.91,negative predict value（NPV）=0.86,positive predict value（PPV）=0.94,negative likelihood ratio（-LR）=0.1,positive likelihood ratio（＋LR）=10.1,and accuracy（AAC）=0.91;and for the random urinary（micro） albumin/ creatinine ratio,the S=0.96,Sp=0.88,NPV=0.94,PPV=0.93,-LR=0.045,＋LR=8.0,ACC=0.93.Conclusion The random urinary（micro） albumin to the creatinine,may be used as the routine test to screen the proteinuria instead of 24 h urine protein test.