CAJ | 학술논문

目的评估即刻尿钙与尿肌酐比值（ ratio of urine calcium to creatinine ， UCa／Cr ）与24小时尿钙（24 hours urine calcium，24 hUC）的相关性，寻找以UCa／Cr代替24 hUC诊断高尿钙的最佳诊断切点，并判断两种方法的一致性。方法选择本科住院患者160例，留取24 hUCa／Cr、即刻尿标本，分别检测24 hUC、即刻尿钙、尿肌酐，计算UCa／Cr，做受试者工作特征（ receiver operating characteristic ， ROC）曲线，寻找最佳诊断切点，并计算其敏感度、特异度、误诊率。采用Bland-Altman 绘图和数据分析，比较UCa／Cr与24 hUC一致性。结果 UCa／Cr与24 hUC呈显著正相关（r＝0.510，95％置信区间0.38～0.62， P＝0.000）。以24 hUC为金标准， UCa／Cr的最佳诊断切点为0.162，其敏感度为61.5％～72.7％，特异度为67.8％～75.5％，误诊率达54.7％～73.1％。应用 UCa／Cr 结果预测24 hUC， UCa／Cr 平均低估24 hUC 66.2 mg，95％一致性界限为－324.5～192.0 mg。结论由于误诊率高，一致性差，即刻UCa／Cr比值不能代替24 hUC作为高尿钙诊断指标。
목적평고즉각뇨개여뇨기항비치（ ratio of urine calcium to creatinine ， UCa／Cr ）여24소시뇨개（24 hours urine calcium，24 hUC）적상관성，심조이UCa／Cr대체24 hUC진단고뇨개적최가진단절점，병판단량충방법적일치성。방법선택본과주원환자160례，류취24 hUCa／Cr、즉각뇨표본，분별검측24 hUC、즉각뇨개、뇨기항，계산UCa／Cr，주수시자공작특정（ receiver operating characteristic ， ROC）곡선，심조최가진단절점，병계산기민감도、특이도、오진솔。채용Bland-Altman 회도화수거분석，비교UCa／Cr여24 hUC일치성。결과 UCa／Cr여24 hUC정현저정상관（r＝0.510，95％치신구간0.38～0.62， P＝0.000）。이24 hUC위금표준， UCa／Cr적최가진단절점위0.162，기민감도위61.5％～72.7％，특이도위67.8％～75.5％，오진솔체54.7％～73.1％。응용 UCa／Cr 결과예측24 hUC， UCa／Cr 평균저고24 hUC 66.2 mg，95％일치성계한위－324.5～192.0 mg。결론유우오진솔고，일치성차，즉각UCa／Cr비치불능대체24 hUC작위고뇨개진단지표。
Objective To determine extent of correlation of spot ratio of urine calcium to reatinine ( UCa/Cr) with 24 hours urine calcium (24 hUC) and to find the cut point of UCa/Cr for diagnosis.We also evaluated the accordance of UCa/Cr and 24 hUC measurements.Methods We collected the 24-hour urine samples and the spot urine samples, detected 24 hUC, urinary calcium and creatinine, then calculated UCa/Cr.The receiver operating characteristic (ROC) curve was drawn to find the cut point of UCa/Cr for diagnosis of hypercalciuria.We evaluated the sensitivity, specificity and the misdiagnosis rate and consistency of UCa/Cr with the 24 hUC with Bland-Altman analysis.Results UCa/Cr were positively correlated with 24 hUC significantly ( r=0.510 , 95%confidence interval:0.38-0.62 , P=0.000).When we made the 24 hUC the golden standard, the cut point of UCa/Cr was 0.162, with the sensitivity and specificity of 61.5% -72.7% and 67.8% -75.5%, respectively.The misdiagnosis rate were as high as from 54.7% to 73.1%.UCa/Cr was average 66.2 mg lower than 24 hUC with 95%confidence interval of -324.5 to 192. Conclusion UCa/Cr measurements, although has a reasonable correlation, but poor consistency with the 24 hUC measurements.Clinicians should still use the 24 hUC to diagnose hypercalciuria compared to spot UCa/Cr ratio.