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目的探讨不同时段尿白蛋白检测在早期糖尿病肾损伤诊断中的临床应用。方法收集2013年2月~2014年3月于宝安区松岗人民医院就诊的糖尿病患者106例及表面健康人30例,自入院后连续3d,收集尿液标本,分别测量随机尿、晨尿、午间餐后尿、夜间尿、24h尿的UA浓度、尿Cr及24h尿的总尿量,计算不同时间段及24h尿的总UA含量、ACR,分析其与24 h UA的相关性。结果随机尿、晨尿、午间餐后尿、夜间尿UA的天间变异系数均较24h UA升高,但经Cr校正后,其天间变异系数有所降低;随机尿、晨尿、午间餐后尿、夜间尿的UA和ACR与24 h UA的相关系数R分别为0.705和0.801,0.812和0.906,0.658和0.583,0.931和0.977,其中,夜间尿UA与24h UA的相关性最好。结论夜尿UA与24h尿UA的相关性最佳,同时采用Cr进行校正,可有效减少天间变异,最有可能取代24h UA检测作为早期糖尿病患者肾损伤的诊断方法,但尚需进一步研究证实。
Objective To investigate the clinical application of urinary albumin in different periods in the diagnosis of early diabetic nephropathy. Methods From February 2013 to March 2014, 106 patients with diabetes mellitus and 30 healthy people were selected for treatment in Songgang People’s Hospital of Bao’an District. Urine samples were collected for three consecutive days after admission. Random urine, morning urine, Lunchtime postprandial urine, nocturnal urine, urinary UA concentration of 24h urine, urinary Cr and urine total urinary output of 24h. Calculate the total UA content and ACR in different time periods and 24h urine, and analyze its correlation with 24 h UA. Results The coefficient of variation of UA in random urine, morning urine, lunchtime urine and nighttime UA was higher than that of 24h UA, but the coefficient of variation in the inter-day was decreased after Cr correction. The random coefficient of urine, morning urine, midday meal The correlation coefficient R of UA, ACR and 24-hour UA of post-nocturia, nocturnal urine were 0.705 and 0.801,0.812 and 0.906,0.658 and 0.583,0.931 and 0.977, respectively. The correlation between night UA and 24h UA was the best. Conclusions The correlation between nocturnal urinary UA and 24h urinary UA is the best, meanwhile using Cr for correction, which can effectively reduce the inter-temporal variation and is most likely to replace 24h UA as a diagnostic method for renal injury in patients with early diabetes. However, further study is needed to confirm .