随机尿清蛋白肌酐比在高血压及糖尿病肾损伤早期诊断的应用价值

目的：探讨随机尿微量清蛋白肌酐比（ACR）在高血压及糖尿病致肾早期损伤的诊断应用价值。方法高血压和糖尿病患者共102例（糖尿病50例，高血压52例），按1989年Mogensen标准，根24 h尿清蛋白排泄率（UAER）分为：正常组（UAER＜30 mg／24 h）、微量组（UAER 30～300 mg／24 h ）、大量组（UAER＞300 mg／24 h）。留取24 h尿检测 UAER ，并取随机尿同时测微量清蛋白（UmAlb）、尿肌酐（Cr）计算 ACR结果进行比较。结果随机尿ACR与24 h UAER呈现明显相关性，差异无统计学意义。在肾损伤的敏感性比较中，ACR的阳性率高于UmAlb ，差异有统计学意义。结论随机尿ACR与24 h UAER及UmAlb有极好的相关性，对肾损伤的诊断敏感性好于UmAlb ，ACR可以替代24 h UAER作为肾损伤早期诊断的有效指标。

Application of random urine ACR for the early diagnosis of renal injury in hypertension and diabetes

Objective To investigate the value of random urinary albumin to creatinine ratio （ACR） for the early diagnosis of renal injury in hypertension and diabetes .Methods A total of 102 cases of patients ,including 50 cases with diabetes and 52 cases with hypertension .According to the 1989 Mogensen criteria and 24 h protein excre‐tion rate （UAER） ,all patients were divided into three groups ,including normal group （UAER〈30 mg/24 h） ,trace group （UAER 30‐300 mg/24 h） and large group （UAER〉300 mg/24 h） .Random urine albumin （UmAlb） and cre‐atinine （Cr） were detected ,and levels of ACR were calculated and compared among all groups .Results Level of ran‐dom urinary ACR was significantly correlated with 24 h UAER ,and there was no significant difference between them .The positive rate of ACR was higher than UmAlb ,with significant difference .Conclusion Random urinary ACR might be correlated with 24 h UAER and UmAlb ,and the sensitivity of random urinary ACR could be higher than UmAlb in the diagnosis of renal injury .