清晨尿微量白蛋白尿肌酐比测定在糖尿病肾病患者肾小球损害诊断中的价值分析

陈永雪　梁志洪　陈结贞　田映雪

[摘要] 目的 探讨清晨尿微量白蛋白尿肌酐比（UmAlb/Ucr）测定对糖尿病肾病（DN）早期肾小球损害的诊断价值。 方法 选取100例DN患者为观察组，100例健康人员为对照组，收集两组清晨静脉血、尿标本，分析两组尿微量白蛋白尿肌酐比（UmAlb/Ucr），血清胱抑素C（CysC），血肌酐（Scr）及血尿素氮（BUN）四种方法的检测结果及诊断效能。 结果 观察组UmAlb/Ucr及CysC均显著高于对照组，而在Scr 、BUN 水平上未见差异；同时研究中UmAlb/Ucr与CysC无论是在灵敏度，特异度还是准确度均未见显著差异，且在三项效能上均明显高于Scr、BUN两种检查（P<0.05）；而Scr与BUN比较，灵敏度、特异度及准确度均无明显差异。 结论 清晨UmAlb测定配合UCr进行校正，能够及时发现DN患者早期肾小球损害，操作简便，特异度、灵敏度高，值得临床推广应用。

[关键词] 尿微量白蛋白尿肌酐比；糖尿病肾病；肾小球损伤

[中图分类号] R587.2 [文献标识码] B [文章编号] 2095-0616（2016）09-134-04

[Abstract] Objective To study the diagnostic value of urine micro albumin/ urine creatinine （UmAlb/Ucr） on renal injury in patients with Diabetic nephropathy. Methods 100 DN patients were chosen as observation group， and 100 healthy people were selected as control group. The venous blood and urine of the 2 groups were collected in morning. The results of the determination was analyzed， such as UmAlb/Ucr， cystatin C （CysC）， serum creatinine（Scr） and usea nitrogen （BUN）. The diagnostic efficiency was diagnosed. Results The level of UmAlb/Ucr and CysC of observation group were much higher than those of the control group. There was no difference in the level of BUN and Scr between the two groups. UmAlb/Ucr and CysC showed no significant difference in sensitivity， specificity and accuracy. The three efficacy was significantly higher than Scr and BUN （P<0.05）. There was no significant difference in sensitivity， specificity and accuracy between Scr and BUN. Conclusion UmAlb determination with UCr can be timely detection of early glomerular damage in patients with Diabetic nephropathy， owning a significant effect， worthy of clinical. It is easy to operate， specificity， high sensitivity. It is worthy of clinical application.

[Key words] Urine micro albumin / urine creatinine； Diabetic nephropathy； Renal injury

肾小球疾病发病早期常常无明显的临床表现，实验室常规方法检测尿蛋白、血浆尿素氮、肌酐等也难以明确诊断[1]；而糖尿病是临床常见的内分泌系统疾病，糖尿病肾病（diabetic nephropathy，DN）是糖尿病严重并发症，其早期主要病变为肾小球硬化和肾小管重吸收障碍，晚期可出现严重的肾功能衰竭，是一种典型的肾小球硬化性病变[2]，因此本组研究选取DN患者作为研究对象，采用晨尿微量白蛋白与尿肌酐比（UmAlb/Ucr）检测手段对糖尿病肾小球病变进行早期诊断并与当前流行的血清胱抑素C（CysC）进行对比，现将结果报道如下。

1 资料与方法

1.1 一般资料

选取2013年1月～2015年6月来我院就诊的100例DN患者，设为观察组，另从同期来院体检的健康人群中抽取100例作为对照组，两组分别有男66例、68例；女34例，32例；平均年龄（53.8±6.6）、（55.1±6.7）岁；平均体质指数分别为（24.5±1.2）、（23.9±1.3）kg/m2；……