中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2010年
11期
807-811
,共5页
樊晓红%蔡建芳%高碧霞%牟利军%李金红%刘雪姣%吴俊雪%孟庆艳%王海云%刘莉莉%李航%李雪梅%李学旺
樊曉紅%蔡建芳%高碧霞%牟利軍%李金紅%劉雪姣%吳俊雪%孟慶豔%王海雲%劉莉莉%李航%李雪梅%李學旺
번효홍%채건방%고벽하%모리군%리금홍%류설교%오준설%맹경염%왕해운%류리리%리항%리설매%리학왕
白蛋白尿%尿分析%自蛋白肌酐比值%微量白蛋白尿%受试者工作特征曲线
白蛋白尿%尿分析%自蛋白肌酐比值%微量白蛋白尿%受試者工作特徵麯線
백단백뇨%뇨분석%자단백기항비치%미량백단백뇨%수시자공작특정곡선
Albuminuria%Urinalysis%Albumin-creatinine ratio%microalbuminuria%Receiver operator characteristic curve
目的 探讨中国汉族人群以晨尿白蛋白肌酐比值(ACR)诊断微量白蛋白尿(MA)的界值.方法 本研究对象来自于北京平谷区代谢综合征肾损害流行病学调查,随机整群抽取的部分受试者除外脓尿或者镜下血尿后自愿留取8 h过夜尿.以8 h尿白蛋白排泄率(UAE)作为诊断标准,应用受试者工作特征曲线(ROC)方法确定MA的诊断界值.结果 (1)共1056人(男性494人、女性562人,年龄20～75岁)纳入本研究,MA的患病率为12.5%,临床蛋白尿患病率为1.7%.(2)ROC确定诊断MA的ACR下界值:男性1.95 g/mol(敏感性97.6%,特异性88.6%),女性3.62 g/mol(敏感性83.8%,特异性89.1%),总体受试者ACR下界值为2.78 g/mol(敏感性88.7%,特异性86.0%);上界值:总体受试者ACR上界值为22.59g/mol(敏感性100.0%,特异性98.8%).(3)与8 h尿UAE诊断MA的一致性检验显示本研究按性别区分的诊断界值敏感性91.3%,特异性88.2%,阳性及阴性似然比为7.96和0.10,阳性及阴性预测值为56.9%和98.4%.结论 晨尿诊断MA的ACR下界值存在性别差异,男性1.95 g/mol,女性3.62 g/mol,较目前国际推荐的性别特异性ACR诊断值偏高,具有良好的诊断性.
目的 探討中國漢族人群以晨尿白蛋白肌酐比值(ACR)診斷微量白蛋白尿(MA)的界值.方法 本研究對象來自于北京平穀區代謝綜閤徵腎損害流行病學調查,隨機整群抽取的部分受試者除外膿尿或者鏡下血尿後自願留取8 h過夜尿.以8 h尿白蛋白排洩率(UAE)作為診斷標準,應用受試者工作特徵麯線(ROC)方法確定MA的診斷界值.結果 (1)共1056人(男性494人、女性562人,年齡20～75歲)納入本研究,MA的患病率為12.5%,臨床蛋白尿患病率為1.7%.(2)ROC確定診斷MA的ACR下界值:男性1.95 g/mol(敏感性97.6%,特異性88.6%),女性3.62 g/mol(敏感性83.8%,特異性89.1%),總體受試者ACR下界值為2.78 g/mol(敏感性88.7%,特異性86.0%);上界值:總體受試者ACR上界值為22.59g/mol(敏感性100.0%,特異性98.8%).(3)與8 h尿UAE診斷MA的一緻性檢驗顯示本研究按性彆區分的診斷界值敏感性91.3%,特異性88.2%,暘性及陰性似然比為7.96和0.10,暘性及陰性預測值為56.9%和98.4%.結論 晨尿診斷MA的ACR下界值存在性彆差異,男性1.95 g/mol,女性3.62 g/mol,較目前國際推薦的性彆特異性ACR診斷值偏高,具有良好的診斷性.
목적 탐토중국한족인군이신뇨백단백기항비치(ACR)진단미량백단백뇨(MA)적계치.방법 본연구대상래자우북경평곡구대사종합정신손해류행병학조사,수궤정군추취적부분수시자제외농뇨혹자경하혈뇨후자원류취8 h과야뇨.이8 h뇨백단백배설솔(UAE)작위진단표준,응용수시자공작특정곡선(ROC)방법학정MA적진단계치.결과 (1)공1056인(남성494인、녀성562인,년령20～75세)납입본연구,MA적환병솔위12.5%,림상단백뇨환병솔위1.7%.(2)ROC학정진단MA적ACR하계치:남성1.95 g/mol(민감성97.6%,특이성88.6%),녀성3.62 g/mol(민감성83.8%,특이성89.1%),총체수시자ACR하계치위2.78 g/mol(민감성88.7%,특이성86.0%);상계치:총체수시자ACR상계치위22.59g/mol(민감성100.0%,특이성98.8%).(3)여8 h뇨UAE진단MA적일치성검험현시본연구안성별구분적진단계치민감성91.3%,특이성88.2%,양성급음성사연비위7.96화0.10,양성급음성예측치위56.9%화98.4%.결론 신뇨진단MA적ACR하계치존재성별차이,남성1.95 g/mol,녀성3.62 g/mol,교목전국제추천적성별특이성ACR진단치편고,구유량호적진단성.
Objective To investigate the discriminator value of Han Chinese first morning urine albumin creatinine ratio (ACR) for determining the microalbuminuria. Methods A total of 1056 participants (494 males and 562 females) were selected from epidemiologic study of the metabolic syndrome and chronic kidney disease in Pinggu district, Beijing. Eight-hour overnight urinary albumin excretion (UAE) was regarded as the gold standard for defining the albuminuria,and the ROC curve analysis was used to determine the ACR discriminator value for microalbuminuria. Results (1)Microalbuminuria was found in 12.5% of participants,macroalbuminuria in 1.7%. (2)The ACR discriminator value for microalbuminuria by ROC curve analysis was 1.95 g/mol (sensitivity 97.6% and specitivity 88.6%) for men, 3.62 g/mol(sensitivity 83.8% and specitivity 89.1%) for women, 2.78 g/mol (sensitivity 88.7% and specitivity 85.9%)for overall. The upper boundary of microalbuminuria by ROC curve analysis was 22.59 g/mol (sensitivity 100.0% and specitivity 98.8%) . (3)The inter-rater agreement of the result in this study showed that sensitivity was 91.3% and specitivity was 88.2%, positive likelihood ratio was 7.56 and negative likelihood ratio was 0.10, positive predictive value was 56.9% and negative predictive value was 98.4%. Conclusions The ACR discriminator value for determining microalbuminuria is obviously higher in women than that in men, and is higher than recommendation of international guidelines. The result by ROC curve analysis has better sensitivity and specitivity.
