糖化血红蛋白和尿微量白蛋白/肌酐比值检测对糖尿病肾病诊断的临床意义

目的 探讨糖化血红蛋白（HbA1c）和尿微量白蛋白/肌酐比值（UACR）在糖尿病肾病诊断中的临床价值.方法 检测67例糖尿病肾病、87例2型糖尿病非肾病以及120例健康对照组血糖化血红蛋白以及尿微量白蛋白、尿肌酐值.统计分析不同病程患者的糖化血红蛋白以及尿微量白蛋白/尿肌酐比值结果.通过诊断试验评估分析检测HbA1c和UACR对糖尿病肾病诊断的临床价值.结果 HbA1c和UACR水平和糖尿病肾病病程有很密切关系,随病程的延长呈逐步上升趋势.糖尿病肾病组UACR水平与正常组以及2型糖尿病非肾病组相比均具有统计学差异（P＜0.01）.诊断试验评估发现单独检测UACR比单独检测HbA1c对糖尿病肾病的诊断能力强（HbA1c阳性似然比和阴性似然比分别为1.17、0.82;UACR阳性似然比和阴性似然比分别为6.12、0.04）.结论 HbA1c和UACR联合检测可以提高糖尿病肾病的诊断价值,使糖尿病肾病的早期诊断更加稳定可靠.

Clinical significance of glycosylated haemoglobin and urinary albumin to creatinine ratio in the diagnosis of diabetic kidney disease

Objective To investigate the value of the glycosylated haemoglobin （HbA1c） and urinary albumin to creatinine ratio （UACR） in the diagnosis of diabetic kidney disease.Methods HbA1c,microalbuminuria and creatinine were detected in 67 diabetic kidney patients,87 type 2 diabetic non-nephropathy cases and 120 health subjects.The value of HbA1c and UACR in different course of diabetic kidney and type 2 diabetic non-nephropathy were analyzed.Results The HbA1c and UACR had a rising trend according to the development of diabetic kidney.UACR level of diabetic nephropathy group showed statistical significant difference compared with those of normal group and type 2 diabetic non-nephropathy group （P ＜ 0.01）.Single diagnosis of UACR had higher diagnosis ability than those of HbA1c during the diagnostic test （positive likelihood ratio and negative likelihood ratio in HbA1c were 1.17 and 0.82; positive likelihood ratio and negative likelihood ratio in UACR were 6.12 and 0.04）.Conclusion Combined detection of HbAlc and UACR can improve the diagnosis of diabetic kidney,making the diagnostic results more stabile and reliable.