探讨尿微量白蛋白/肌酐比值在糖尿病肾病早期诊断中的应用(1)
【摘要】 目的 探究糖尿病肾病患者早期诊断中检测其尿微量白蛋白(UMA)/肌酐比值(ACR)的价值。方法 选取60例糖尿病肾病患者作为观察组， 另选取60例同期在本院进行常规体检的健康者作为对照组。两组受试者均行UMA、尿肌酐检测， 并计算ACR， 另检测所有受试者血肌酐水平。观察并比较两组受试者UMA、血肌酐及ACR水平;观察并比较观察组中不同病程长度患者的UMA、血肌酐及ACR水平;观察并比较观察组中不同糖尿病分期患者UMA、血肌酐及ACR水平。结果 观察组患者的UMA(104.30±18.75)mg/L、血肌酐(148.67±14.73)μmol/L、ACR(68.93±11.58)mg/g均高于对照组受试者的(15.23±2.66)mg/L、(61.22±5.35)μmol/L、(2.58±1.46)mg/g， 差异具有统计学意义(P<0.05)。观察组患者中， 病程<5年者18例， 病程5～15年者32例， 病程>15年者10例;病程>15年者UMA、血肌酐、ACR水平均高于病程5～15年者及病程<5年者， 病程5～15年者UMA、血肌酐、ACR水平均高于病程<5年者， 差异均具有统计学意义(P<0.05)。观察组患者中， 糖尿病Ⅰ期患者16例， Ⅱ期患者21例，Ⅲ期患者15例， Ⅳ期患者8例;Ⅳ期患者UMA、血肌酐、ACR水平均高于Ⅰ期、Ⅱ期、Ⅲ期患者，Ⅲ期患者UMA、尿肌酐、血肌酐、ACR水平均高于Ⅰ期、Ⅱ期患者， Ⅱ期患者UMA、血肌酐、ACR水平均高于Ⅰ期患者， 差异均具有统计学意义(P<0.05)。结论 糖尿病肾病患者早期诊断中对其UMA、血肌酐进行检测， 并及時计算ACR可明确患者的病情， 对患者后续治疗以及治疗方案的调整均具有重要的指导意义， 可在临床中对该种诊断方法进行推广。
【关键词】 尿微量白蛋白;尿微量白蛋白/肌酐比值;血肌酐;糖尿病肾病;早期诊断
DOI：10.14163/j.cnki.11-5547/r.2019.24.005
Discussion on the application of urinary microalbumin/creatinine ratio in early diagnosis of diabetic nephropathy ZHOU Zheng-wei， WU Li-li， TANG Jin-song. Dongguan Dalang Hospital， Dongguan 523770， China
【Abstract】 Objective To investigate the value of urinary microalbumin (UMA)/ creatinine ratio (ACR) in early diagnosis of diabetic nephropathy. Methods There were 60 diabetic nephropathy patients as observation group， and another 60 healthy persons who underwent routine physical examination in our hospital at the same time as the control group. UMA and urine creatinine were measured in both groups， and ACR was calculated. Serum creatinine levels were also measue in all subjects. The levels of UMA， serum creatinine and ACR in the two groups were observed and compared. The UMA， serum creatinine and ACR levels in patients with different courses of disease and different stages of diabetes in the observation group was observed and compared. Results The observation group had higher UMA as (104.30±18.75) mg/L， serum creatinine as (148.67±14.73) μmol/L
and ACR as (68.93±11.58) mg/g than (15.23±2.66) mg/L， (61.22±5.35) μmol/L and (2.58±1.46) mg/g in the control group. Their difference was statistically significant (P<0.05). In the observation group， 18 patients had a disease course <5 years， 32 patients had a disease course of 5-15 years， and 10 patients had a disease course >15 years. The levels of UMA， serum creatinine and ACR in patients with disease course >15 years were higher than those in patients with disease course 5-15 years and <5 years. The levels of UMA， serum creatinine and ACR in patients with disease course 5-15 years were higher than those in patients with disease course <5 years. Their differences were statistically significant (P<0.05). In the observation group， there were 16 patients in stage Ⅰdiabetes mellitus， 21 patients in stage Ⅱ， 15 patients in stage Ⅲ and 8 patients in stage Ⅳ. The levels of UMA， serum creatinine and ACR in patients with stage Ⅳ were higher than those in patients with stage Ⅰ， Ⅱ and Ⅲ. The levels of UMA， serum creatinine and ACR in patients with stage Ⅲ were higher than those in patients with stage Ⅰ and Ⅱ. The levels of UMA， serum creatinine and ACR in patients with stage Ⅱ were higher than those in patients with stage Ⅰ. Their differences were statistically significant (P<0.05). Conclusion UMA， urine creatinine and serum creatinine can be detected in the early diagnosis of diabetic nephropathy， and ACR can be calculated in time to define the patient’s condition. This method has important guiding significance for the follow-up treatment of patients and the adjustment of treatment plan. This diagnosis method can be popularized in clinical practice., http://www.100md.com(周正维 吴莉莉 唐劲松)
【关键词】 尿微量白蛋白;尿微量白蛋白/肌酐比值;血肌酐;糖尿病肾病;早期诊断
DOI：10.14163/j.cnki.11-5547/r.2019.24.005
Discussion on the application of urinary microalbumin/creatinine ratio in early diagnosis of diabetic nephropathy ZHOU Zheng-wei， WU Li-li， TANG Jin-song. Dongguan Dalang Hospital， Dongguan 523770， China
【Abstract】 Objective To investigate the value of urinary microalbumin (UMA)/ creatinine ratio (ACR) in early diagnosis of diabetic nephropathy. Methods There were 60 diabetic nephropathy patients as observation group， and another 60 healthy persons who underwent routine physical examination in our hospital at the same time as the control group. UMA and urine creatinine were measured in both groups， and ACR was calculated. Serum creatinine levels were also measue in all subjects. The levels of UMA， serum creatinine and ACR in the two groups were observed and compared. The UMA， serum creatinine and ACR levels in patients with different courses of disease and different stages of diabetes in the observation group was observed and compared. Results The observation group had higher UMA as (104.30±18.75) mg/L， serum creatinine as (148.67±14.73) μmol/L
and ACR as (68.93±11.58) mg/g than (15.23±2.66) mg/L， (61.22±5.35) μmol/L and (2.58±1.46) mg/g in the control group. Their difference was statistically significant (P<0.05). In the observation group， 18 patients had a disease course <5 years， 32 patients had a disease course of 5-15 years， and 10 patients had a disease course >15 years. The levels of UMA， serum creatinine and ACR in patients with disease course >15 years were higher than those in patients with disease course 5-15 years and <5 years. The levels of UMA， serum creatinine and ACR in patients with disease course 5-15 years were higher than those in patients with disease course <5 years. Their differences were statistically significant (P<0.05). In the observation group， there were 16 patients in stage Ⅰdiabetes mellitus， 21 patients in stage Ⅱ， 15 patients in stage Ⅲ and 8 patients in stage Ⅳ. The levels of UMA， serum creatinine and ACR in patients with stage Ⅳ were higher than those in patients with stage Ⅰ， Ⅱ and Ⅲ. The levels of UMA， serum creatinine and ACR in patients with stage Ⅲ were higher than those in patients with stage Ⅰ and Ⅱ. The levels of UMA， serum creatinine and ACR in patients with stage Ⅱ were higher than those in patients with stage Ⅰ. Their differences were statistically significant (P<0.05). Conclusion UMA， urine creatinine and serum creatinine can be detected in the early diagnosis of diabetic nephropathy， and ACR can be calculated in time to define the patient’s condition. This method has important guiding significance for the follow-up treatment of patients and the adjustment of treatment plan. This diagnosis method can be popularized in clinical practice., http://www.100md.com(周正维 吴莉莉 唐劲松)