2型糖尿病肾脏疾病尿清蛋白/尿肌酐的分析

摘要

目的 探讨尿清蛋白/尿肌酐比(urinary albumin creatinine ratio,UACR)与2型糖尿病(type 2 diabetes mellitus,T2DM)肾脏疾病(kindney disease,DKD)患者病变程度及早期诊断价值.方法 根据UACR将199例2型糖尿病患者分为单纯糖尿病(A)组(n=60)、早期糖尿病肾脏疾病(DKD)(B)组(n=60)和临床DKD(C)组(n=79),另选健康体检者作为对照(D)组(n=50),分别测定各组尿清蛋白(U-ALB)、尿肌酐计算UACR,24 尿清蛋白计算UAER,并进行组间比较.结果 各T2DM组UAER和UACR水平组与对照组之间比较差异均具有统计学意义(P<0.05),B,C组显著高于A组(P<0.05),C与B组相比亦明显升高(P<0.05).在DKD早期UACR优于UAER;直线回归分析UACR与UAER正相关(r=0.91,P<0.01);以38.4 mg/g为切点诊断DKD的敏感度与特异度为93.3%和96.4%,诊断早期DKD的敏感度与特异度分别为91.7%和95%.结论 UACR与DKD的病变程度相关且对DKD的诊断可以代替UAER检查.%Objective To investigate the association of urinary ajbumin creatinine ratio(UACR) with type 2 diabetes kindney disease DKD. Methods According to the results of UACR ,199 T2DM cases divided into simple diabetic mellitus(A =60),early DKD (B = 60) and clinical DKD (C = 79);other 50 healthy persons were employed as control. Level of U-ALB,UACR and UAER of all groups were examined. Results There was signilicant diffferent of UACR and UAER level in all groups as compared with control group(P＜0. 05). UACR and UAER level in group B and group C were significantly higher than those in the group A and control groups (P＜0. 05) ,and those in group C significantly higher than in group B. Correlation analysis suggested that UACR was positively correlated with UAER (r=0. 91,P＜0. 01) Conclusion UACR and DKD was closely related to the occurrence,development,UACR could replace UAER inspection.