目的 验证和评价Tanaka(T法)和SH2(S法)两种方法在上海地区高血压患者中估算24h尿钠排泄量的可行性和准确性.方法 留取2017年1月-2018年1月在海军军医大学长海医院内科病房住院的180例高血压患者晨尿、午尿及夜间尿样本,并留取24h尿样.检测3个时点尿样和24h尿样中的钠、钾和肌酐水平,使用T法和S法计算.对T法和S法的估算值与实测值之间的偏差进行比较,采用Bland-Altman法比较两种方法所估算出的24h尿钠排泄量与实际尿钠排泄量之间的一致性.结果 共有122例患者纳入最终分析,实测24h尿钠排泄量平均值为151.02mmol(约为盐8.83g).T法估测尿钠排泄量在3个时点的平均偏差值(估算值-24h实际观察值)分别为34.99、22.72, 48.76mmol/L,S法在3个时点的平均偏差值分别为-6.83、-6.82、-6.31mmol/L.T法在晨尿、S法在3个时点尿样中的组内相关系数(ICC)较高.Bland-Altman法显示24h尿钠排泄量水平越高,S法出现的偏倚越大,具有线性趋势.结论 因存在不同程度的局限,T法及S法均不适合估算患者个体的24h尿钠排泄量;T法及S法适合估算人群的24h尿钠平均水平,而S法相较T法更为准确.%Objective To validate and evaluate the feasibility and accuracy of Tanaka (T method) and SH2 (S method) used to estimate the 24-hour urinary sodium excretion of patients in Shanghai with hypertension. Methods A hundred and eighty hypertensive patients, hospitalized in the Internal Medicine Ward of Changhai Hospital affiliated to Navy Medical University from January 2017 to January 2018, were enrolled in present study. The specimens were collected of morning urine, afternoon urine, evening urine and the completed 24h urine, and the levels of sodium, potassium and creatinine in urine specimens were detected. The differences of estimation value calculated by T method and S method were compared, and the consistency of estimated value and actual urinary sodium excretion were compared by Bland-Altman plots respectively. Results There were 122 patients were enrolled in the final statistical analysis. The average urinary sodium excretion was 151.02mmol (about 8.83g salt). The average deviation values estimated by T method at 3 time points were 34.99, 22.72 and 48.76mmol, and estimated by S method were -6.83, -6.82,-6.31mmol. The intra-group correlation coefficient (ICC) was higher of T method in morning urine specimen and of S method in three time spots urine specimens. Bland-Altman plots showed that the higher the level of 24h urine sodium excretion, the greater the bias of S method with a linear trend. Conclusion Because of the varying degrees of limitation, both T and S methods are not suitable for estimating the individual 24h urinary sodium excretion. The two methods are suitable for estimating the average 24h urinary sodium level of population, while S method is more accurate than T method.
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