[1]刘荣凤,石岩岩,栾海霞,等.尿蛋白定性和定量及尿清蛋白与总蛋白比值临床价值研究[J].现代检验医学杂志,2016,31(06):105-107，111.[doi:10.3969/j.issn.1671-7414.2016.06.030]
　LIU Rong-feng,SHI Yan-yan,LUAN Hai-xia,et al.Correlation between Urine Qualitative Test and Protein Quantitation and Clinical Value of Urine Albumin/Protein Ratio in Proteinuria[J].Journal of Modern Laboratory Medicine,2016,31(06):105-107，111.[doi:10.3969/j.issn.1671-7414.2016.06.030]
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尿蛋白定性和定量及尿清蛋白与总蛋白比值临床价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第31卷
期数:
2016年06期
页码:
105-107，111
栏目:
论著
出版日期:
2016-12-20

文章信息/Info

Title:
Correlation between Urine Qualitative Test and Protein Quantitation and Clinical Value of Urine Albumin/Protein Ratio in Proteinuria
作者:
刘荣凤1; 石岩岩2; 栾海霞1; 张永志1; 牟莉1; 周玲1; 袁慧1; 曾小莉1
1.首都医科大学附属北京安贞医院检验科,北京 100029; 2.北京大学第三医院临床流行病学研究中心,北京 100191
Author(s):
LIU Rong-feng1; SHI Yan-yan2; LUAN Hai-xia1; ZHANG Yong-zhi1; MOU Li1; ZHOU Ling1 YUAN Hui1; ZENG Xiao-li1
1.Department of Laboratory Medicine, Beijing Anzhen Hospital Affiliated to Capital Medical University,Beijing100029,China; 2.Clinical Epidemiology Center,the Third Hospital of Beijing University,Beijing 100191,China
关键词:
尿清蛋白;  尿总蛋白;  尿液干化学试纸法;  尿清蛋白/尿总蛋白;  蛋白尿
分类号:
R446.112
DOI:
10.3969/j.issn.1671-7414.2016.06.030
文献标志码:
A
摘要:
目的 比较尿蛋白定性和定量的三个指标干化学法尿蛋白、尿清蛋白、尿总蛋白及尿清蛋白与总蛋白比值应用于蛋白尿筛查的研究。方法选取2015年10月～2016年7月于首都医科大学附属北京安贞医院就诊患者282例新鲜样本,分别进行尿蛋白干化学试纸法、尿清蛋白和尿总蛋白定量分析。比较尿蛋白干化学试纸法各组区分尿蛋白的能力。研究检测尿蛋白三个指标的相关关系。最后分析尿清蛋白与总蛋白比值在正常清蛋白尿、轻度清蛋白尿、大量清蛋白尿之间的差异。结果①尿蛋白干化学试纸法结果为-,±,+,++,+++组对应的尿清蛋白、尿总蛋白及尿清蛋白与总蛋白比值分别为21.91±6.23,145.60±26.82,457.11±81.63,3 957.48±1 171.65,4 300±1 445.11 mg/L; 114.02±4.87,233.86±23.39,718.05±100.98,6 347.62±2 023.12,8 527.43±1 291.39 mg/L; 16.58%±1.26%,30.79%±3.60%,55.98%±4.31%,67.70%±4.20%,75.44%±4.93%。除弱阳性组外,尿蛋白干化学定性阳性各组与阴性组相比,尿清蛋白和尿总蛋白定量结果之间的差异均有统计学意义(F=68.196～81.66,P值均<0.01); 尿蛋白干化学阳性各组与阴性组相比,尿清蛋白与总蛋白比值之间的差异均有统计学意义(F=46.63,P<0.001)。②尿清蛋白/肌酐低于30 mg/g时,干化学蛋白定性、尿清蛋白、总蛋白相关性较差(尿清蛋白、尿总蛋白与尿蛋白干化学试纸法Spearman系数分别为0.049,0.225,P=0.534,P<0.01; 尿清蛋白与总蛋白Pearson相关系数为0.684,P<0.01); 尿清蛋白/肌酐高于30 mg/g时,三者相关性良好(尿清蛋白、尿总蛋白与干化学蛋白定性Spearman系数分别为0.736和0.806,P值均<0.01; 尿清蛋白与总蛋白Pearson相关系数为0.989,P<0.01)。③正常清蛋白尿组、轻度清蛋白尿组和大量清蛋白尿组比较,其尿清蛋白与总蛋白比值之间的差异均有统计学意义(F=365.266,P<0.01)。结论 干化学尿蛋白定性无法正确区分尿蛋白阴性和弱阳性。可以采用尿清蛋白与总蛋白比值在高危人群中筛查蛋白尿。
Abstract:
Objective To investigate the correlation between urine albumin,urine protein and qualitative urine protein and diagnostic value of urine albumin/protein ratio in proteinuria.Methods Urine albumin,protein and qualitative urine protein of 282 patients in BeijingAnzhen Hospital during October 2015 to July 2016 were detected.The difference of urine albumin,urine protein and urine albumin/protein ratio between groups were analyzed according to qualitative urine protein test.Then the correlations between urine albumin,urine protein and qualitative urine protein were analysed.Finally,the difference of urine albumin/protein ratio between normal albuminuria,mild albuminuria,macro albuminuria was analyzed.Results ①According to qualitative urine protein results “-,±,+,++,+++”,corresponding urine albumin and protein and urine albumin/protein ratio were 21.91±6.23,145.60±26.82,457.11±81.63,3 957.48±1 171.65,4 300±1 445.11 mg/L; 114.02±4.87,233.86±23.39,718.05±100.98,6 347.62±2 023.12,8 527.43±1 291.39 mg/L; 16.58%±1.26%,30.79%±3.60%,55.98%±4.31%,67.70%±4.20%,75.44%±4.93%.There was significant difference in urine albumin and protein between positive groups and negative group except for trace positive group.There was significant difference in urine albumin/protein ratio between positive groups and negative group.②When ACR was lower than 30 mg/g,thecorrelation between protein dipstick test results and urine albumin and urine protein was poor(Spearman's correlation coefficient were 0.049 and 0.225,P=0.534,P<0.01.Pearson correlation coefficient was 0.684,P<0.01),while the correlation was better when ACR was above 30 mg/g(Spearman's correlation coefficient were 0.736 and 0.806,P<0.01.Pearson's correlation coefficient were 0.989,P<0.01).③There was significant difference in urine albumin/protein ratio between normal albuminuria,mild albuminuria and macro albuminuria(F=365.266,P<0.01).Conclusion It is hard for protein dipstick test to distinguish negative and trace protein urine.Urine albumin/protein ratio can be used to screen for high risk population.

参考文献/References:

[1] Matsushita K,vander Velde M,Astor BC,et al.Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality:a collaborative meta-analysis of general population cohorts[J].Lancet,2010,375(9731):2073-2081.
[2] Levey AS,Coresh J,Bolton K,et al.K/DOQI clinical practice guidelinesfor chronic kidney disease:evaluation,classification,and stratification[J].Am J Kidney Dis,2002,39(2 suppl 1):S1-266.
[3] Hemmelgarn BR,Manns BJ,Lloyd A,et al.Relation between kidney function,proteinuria,and adverse outcomes[J].JAMA,2010,303(5):423-429.
[4] Gansevoort RT,Matsushita K,vander Velde M,et al.Lower estimated GFR and higher albuminuria are associated with adverse kidney outcomes.A collaborative meta-analysis of general and high-risk population cohorts[J].Kidney Int,2011,80(1):93-104.
[5] Kidney Disease:Improving Global Outcomes(KDIGO)CKD Work Group.KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease[J].Kidney Int,2013,3(Suppl):1-150.
[6] Antunes VV, Veronese FJ, Morales JV.Diagnostic accuracy of the protein/creatinine ratio in urine samples to estimate 24 h proteinuria in patients withprimary glomerulopathies:a longitudinal study[J].Nephrol Dial Transplant,2008,23(7):2242-2246.
[7] Mc Taggart MP,Newall RG,Hirst JA,et al.Diagnostic accuracy of point of care tests for detecting albuminuria:a systematic review and meta-analysis[J].Ann Intern Med,2014,160(8):550-557.
[8] Koeda Y,Tanaka F,Segawa T,et al.Comparison between urine albumin to creatinine ratio and urine protein dipstick testing for prevalence and ability to predict the risk for chronic kidney disease in the general population(Iwate-KENCO study):a prospective community-based cohort study[J].BMC Nephrol,2016,17(1):46-53.
[9] Fisher H,Hsu CY,Vittinghoff E,et al.Comparison of associations of urine protein-creatinine ratio versus albumin-creatinine ratio with complicationsof CKD:a cross-sectional analysis[J].Am J Kidney Dis,2013,62(6):1102-1108.
[10] 刘青艳,李海霞,李志艳,等.尿蛋白试纸条定性与尿清蛋白/肌酐比值的相关性分析[J].临床检验杂志,2015,33(6):423-426. Liu QY,Li HX,Li ZY,et al.Correlation between dipstick test for proteinuria and urine albumin-creatinine ratio[J].Chinese Journal of Clinical Laboratory Science,2015,33(6):423-426.
[11] 陈 宾,谈春荣,赵旭宏,等.国产尿液干化学试纸法检测尿微量清蛋白的可靠性评价[J].现代检验医学杂志,2011,26(3):151-152,154. Chen B,Tan CR,Zhao XH,et al.Evaluation of the reliability of a nativeurine dry chemistry test paper method to detect urine microalbumin[J].Journalof Modern Laboratory Medicine,2011,26(3):151-152,154.
[12] Naresh CN,Hayen A,Craig JC,et al.Day to day variability in spot urine albumin-creatinine ratio measurements[J].Am J Kidney Dis,2013,62(6):1095-1101.
[13] Naresh CN,Hayen A,Craig JC,et al.Day-to-day va-riability in spoturine protein-creatinine ratio measurements[J].Am J Kidney Dis,2012,60(4):561-566.
[14] Mattix HJ,Hsu C,Shaykevich S,et al.Use of the albumin/creatinine ratio to detect microalbuminuria:implications of sex and race[J].J Am Soc Nephrol,2002,13(4):1034-1039.
[15] Kim SM,Lee CH,Lee JP,et al.The association between albumin to creatinine ratio and total protein to creatinine ratio in patients with chronic kidneydisease[J].Clin Nephrol,2012,78(5):346-352.
[16] Atkins RC,Briganti EM,Zimmet PZ,et al.Association between albuminuria and proteinuria in the general population: the Aus Diab Study[J].Nephrol Dial Transplant,2003,18(10):2170-2174.
[17] 郭 玮,潘柏申.尿清蛋白检测标准化进展及实验室应注意的问题[J].中华检验医学杂志,2015,38(9):577-579. Guo W,Pan BS.Highlight on clinical application and standardization of urinary albumin[J].Chin J Lab Med,2015,38(9):577-579.

备注/Memo

备注/Memo:
基金项目:北京市卫生系统高层次卫生技术人才培养项目(NO.2015-3-052)。 作者简介:刘荣凤(1981-),女,硕士,医师,主要从事临床生化与免疫,Tel:15210467952,E-mail:aser1981@sina.com。 通讯作者:曾小莉,女,主任技师,E-mail:greatzxl@163.com。
更新日期/Last Update: 2016-12-20