随机尿微量白蛋白与肌酐比值对2型糖尿病肾病的早期诊断价值

目的:探讨随机尿微量白蛋白与肌酐比值在2型糖尿病早期肾损伤诊断中的临床应用价值。方法:以459例2型糖尿病患者及97例健康体检者为研究对象，采用速率散射比浊法测定随机尿中微量白蛋白（mALB）和肌酐（Cr）含量，并计算mALB与Cr的比值（ACR）。与24 h微量尿白蛋白定量结果进行线性回归分析，确定其相关性。以尿白蛋白排泄率>20 mg/24 h为诊断标准，计算ACR诊断糖尿病肾病的特异性和灵敏度，并初步确定其医学决定水平。结果:随机尿ACR与24 h尿微量白蛋白定量值相关性分析 r =0.738（P <0.01）呈正相关，具有统计学意义，ACR的医学决定水平为2.285 mg/mmol。结论:ACR高于2.285 mg/mmol时，提示医生进行早期干预治疗。

Value of random urinary albumin to creatinine ratio for early diagnosis of type 2 diabetic nephropathy

Objective: To investigate the value of urinary albumin to creatinine ratio（ACR） for early diagnosis of type 2 diabetic nephropathy. Methods: The microalbumin (mALB) and creatinine (Cr) content in random urine of 459 type 2 diabetic patients nephropathy and 97 healthy people was detected through immunoturbidimetric assay, and the ratio of mALB to Cr (ACR) was determined. Linear regression analysis was used to determine the correlation between the results of ACR and urine persistant mALB. Urinary protein excretion rate >20 mg/min was set as the diagnostic criteria to calculate the specificity and sensitivity of ACR in the diagnosis of diabetic nephropathy, and the medical decision level was preliminarily determined. Results: The correlation analysis between random urine ACR and 24 h urine albumin showed a positive correlation between them, with statistical significance[r =0.738 (P <0.01)] , and the medical decision level of ACR was 2.285 (mg/mmol). Conclusion: When ACR is higher than 2.285 (mg/mmol), doctors should perform early intervention.