CAJ | 학술논문

目的：探讨尿电导率（Cond）水平变化对2型糖尿病（T2DM）肾病患者病程进展的临床意义。方法选取武警后勤学院附属医院T2DM患者138例，按24h尿清蛋白定量（24h‐UAE）将其分为正常蛋白尿（NUA）组、微量蛋白尿（LUA）组和大量蛋白尿（MUA）组3个组；然后对其中107例患者按肾小球滤过率重新分为糖尿病肾病（DN）组和糖尿病肾轻度损伤（DC）组。利用SysmexUF‐1000i流式尿液分析仪检测尿液Cond，利用ARKRAYAUTIONMAXAX‐4280分析仪检测尿液比重（SG），利用BNⅡ全自动蛋白分析仪检测尿液微量清蛋白（U‐Alb）。结果MUA组Cond为（14．1±4．5）ms／cm，显著低于LUA组（15．7±4．3）ms／cm（P＜0．05），而LUA组Cond又显著低于NUA组（17．6±5．7）ms／cm（P＜0．05）；MUA组SG为1．011（1．009～1．012），显著低于NUA组1．014（1．010～1．019）和LUA组1．015（1．010～1．020）（P＜0．05）。Cond与SG正相关（r＝0．63，P＜0．05），与24h‐UAE负相关（r＝－0．183，P＜0．05）。DN组尿Cond水平为（13．2±4．3）ms／cm，显著低于DC组（15．0±4．4）ms／cm（P＜0．05），DN组与DC组间SG差异无统计学意义（P＞0．05）。Cond的ROC曲线下面积为0．612（0．502～0．723），当界值设定为11．85时，Cond诊断DN的灵敏度为43．8％，特异度为78．0％。结论尿Cond水平的变化可以反映2型糖尿病肾病的病程进展，但是不能作为其早期筛查指标。
목적：탐토뇨전도솔（Cond）수평변화대2형당뇨병（T2DM）신병환자병정진전적림상의의。방법선취무경후근학원부속의원T2DM환자138례，안24h뇨청단백정량（24h‐UAE）장기분위정상단백뇨（NUA）조、미량단백뇨（LUA）조화대량단백뇨（MUA）조3개조；연후대기중107례환자안신소구려과솔중신분위당뇨병신병（DN）조화당뇨병신경도손상（DC）조。이용SysmexUF‐1000i류식뇨액분석의검측뇨액Cond，이용ARKRAYAUTIONMAXAX‐4280분석의검측뇨액비중（SG），이용BNⅡ전자동단백분석의검측뇨액미량청단백（U‐Alb）。결과MUA조Cond위（14．1±4．5）ms／cm，현저저우LUA조（15．7±4．3）ms／cm（P＜0．05），이LUA조Cond우현저저우NUA조（17．6±5．7）ms／cm（P＜0．05）；MUA조SG위1．011（1．009～1．012），현저저우NUA조1．014（1．010～1．019）화LUA조1．015（1．010～1．020）（P＜0．05）。Cond여SG정상관（r＝0．63，P＜0．05），여24h‐UAE부상관（r＝－0．183，P＜0．05）。DN조뇨Cond수평위（13．2±4．3）ms／cm，현저저우DC조（15．0±4．4）ms／cm（P＜0．05），DN조여DC조간SG차이무통계학의의（P＞0．05）。Cond적ROC곡선하면적위0．612（0．502～0．723），당계치설정위11．85시，Cond진단DN적령민도위43．8％，특이도위78．0％。결론뇨Cond수평적변화가이반영2형당뇨병신병적병정진전，단시불능작위기조기사사지표。
Objective To evaluate the significance of the level change of urinary conductivity (Cond) on the disease progress in the patients with type 2 diabetic nephropathy(DN) .Methods 138 patients with type 2 diabetes mellitus (T2DM) in our hospital were selected and divided into the normoalbuminuria (NUA) ,microalbuminuria (LUA) and macroalbuminuria (MUA) group;then among them 107 cases were re‐divided into the DN group and the diabetes mild renal injury (DC) group .The levels of urinary Cond were measured by using the Sysmex UF‐1000i urine flow cytometer .The urine specific gravity (SG) was detected by the ARKRAY AUTION MAX AX‐4280 analyzer ,and the urine albumin (U‐Alb) was tested by the Siemens BNⅡ automatic protein analyzer .Re‐sults The Cond level in the MUA group was (14 .1 ± 4 .5)ms/cm ,which was lower than (15 .7 ± 4 .3)ms/cm in LUA group(P<0 .05) ,while the Cond level in the LUA group was significantly lower than (17 .6 ± 5 .7) ms/cm in the NUA group(P<0 .05);the SG levels in the NUA group and the LUA group were 1 .014(1 .010-1 .019) and 1 .015(1 .010 -1 .020) respectively ,both were higher than 1 .011(1 .009-1 .012) in the MUA group SG (P<0 .05) .Cond was positively correlated with SG (r=0 .63 ,P<0 .05) and negatively correlated with 24 h‐UAE (r= -0 .183 ,P<0 .05) .The Cond level in the DN group was(13 .2 ± 4 .3)ms/cm ,which was significantly lower than (15 .0 ± 4 .4) ms/cm in the DC group (P<0 .05) ,there was no statistically significant differences in the SG level between the DN group and DC group (P>0 .05) .The area under curve (AUC) of ROC for Cond was 0 .612 (0 .502-0 .723) .When setting the cut‐off vales of Cond as 11 .85 ms/cm ,then the sensitivity was 43 .8% ,and the specificity was 78 .0% . Conclusion The urine Cond level change can reflect the disease progress of DN in T 2DM ,but can not be used as its early screening indicato r .