摘要
目的 分析尿微量白蛋白与尿肌酐比值(urine microalbumin creatinine ratio, ACR)及α1-微球蛋白(alpha l-microglobulin,α1-MG)在老年人群慢性肾病早期检测中的应用。方法 选取2019年10月至2021年10月收治233例临床确诊(高血压组,n1=126例;糖尿病组,n2=61例;冠心病组,n3=46例)病例为疾病组;并选择232例体检人员(n4=232)作为对照组,对以上两组人员进行尿微量白蛋白(microalbuminuria, MALB)、尿肌酐(urine creatinine, UCR)、ACR、尿α1-MG及尿总蛋白(total urine protein, UTP)测定,并采用统计学方法分析两组检测结果差异。结果 在MALB、ACR、α1-MG、UTP检测结果中,高血压组与对照组比较,除ACR、UTP差异有统计学意义外(P<0.05),MALB、α1-MG差异无统计学意义(P>0.05);在糖尿病组与对照组比较中,各项目差异均有统计学意义(P<0.05);在冠心病组与对照组的比较中,MALB、ACR、α1-MG、UTP差异均无统计学意义(P>0.05)。由ROC分析,ACR与α1-MG的联合检查的灵敏度和约登指数均高于各个指标单独检测,AUC为0.977。结论 ACR与α1-MG的联合检查对糖尿病肾损害早期诊断具有重要价值,对高血压肾损害也有诊断意义,能为临床早期发现肾损害提供依据,并指导患者进行治疗方案的选择和评估预后。
Objective The ratio of urinary microalbumin to urinary creatinine(ACR)and α1-microglobulin(α1-MG)were analyzed for the early detection of chronic kidney disease in the elderly population.Methods A total of 233 clinically diagnosed cases were collected(hypertension, n1=126;diabetes, n2=61;coronary heart disease, n3=46)from October, 2019 to October, 2021 for the study, while 232 medical examiners(n4=232)were selected as the control group. All patients were tested for urinary microalbumin(MALB), urinary creatinine(UCR),urinary microalbumin and urinary creatinine ratio(ACR),urine α1-microglobulin(α1-MG)and urinary total protein(UTP).Results The results of MALB, ACR, α1-MG and UTP were as following: compared with the control group, there were no significant differences in MALB and α1-MG except for ACR and UTP(P<0.05);There were statistically significant differences between the diabetic group and the control group(P<0.05);There were no significant differences in MALB, ACR, α1-MG and UTP between the CHD group and control group(P>0.05). By ROC analysis, the sensitivity and Youden index were higher between ACR and 1-MG than each index tested separately, with an AUC of 0.977.Conclusion The joint examination of ACR and α1-MG is important for the early diagnosis of renal damage in diabetes, and also for hypertensive renal impairment, which can provide the reference for the early detection of renal damage in clinical practice, and guide the selection of treatment regimen and evaluate the prognosis.
作者
朱华芳
殷少文
陈光利
郑传志
钱明
黄娟
ZHU Huafang;YIN Shaowen;CHEN Guangli;ZHENG Chuanzhi;QIAN Ming;HUANG Juan(The Third People’s Hospital of Guiyang,Guiyang 550006,China)
出处
《标记免疫分析与临床》
CAS
2022年第6期949-952,共4页
Labeled Immunoassays and Clinical Medicine
基金
贵阳市大健康科技计划项目(编号:2019-9-10)。
关键词
尿白蛋白/肌酐比值
Α1-微球蛋白
慢性肾病
早期检测
Urinary albumin-to-creatinine ratio
α1-Microglobulin
Chronic kidney disease
Early detection
