摘要
目的:探究尿微量白蛋白(UmAlb)、尿肌酐(UCr)及其比值(UACR)与2型糖尿病(T2DM)肾病患者肾脏损伤的关系。方法:回顾性分析笔者所在医院73例T2DM肾病患者及51例T2DM患者的临床资料,将73例T2DM肾病患者设为研究组,并根据24 h尿白蛋白排泄率(UAER)水平将其分轻度肾损伤组(46例)及中度肾损伤组(27例),将51例T2DM患者设为对照组。比较三组一般资料及UmAlb、UCr、UACR水平,评估UmAlb、UCr、UACR与UAER的相关性,并采用受试者工作特征曲线(ROC曲线)评估UmAlb、UACR对T2DM肾病中度肾损伤的诊断价值。结果:三组性别、年龄、体质量指数、吸烟史、饮酒史比较,差异均无统计学意义(P>0.05);三组T2DM病程、高血压患病率及FPG、HbA1c水平比较,差异有统计学意义(P<0.05)。中度肾损伤组UmAlb、UACR水平均明显高于轻度肾损伤组及对照组(P<0.05),且轻度肾损伤组高于对照组,差异有统计学意义(P<0.05)。对照组UCr水平低于中度肾损伤组及轻度肾损伤组(P<0.05),但中度肾损伤组、轻度肾损伤组UCr水平比较,差异无统计学意义(P>0.05)。Pearson相关性分析显示,T2DM肾病患者UmAlb、UACR水平与UAER水平呈显著正相关(r=0.427、0.361,P<0.05),而UCr水平与UAER水平无明显相关性(r=0.214,P>0.05);ROC曲线显示,UmAlb、UACR水平对T2DM肾病中度肾损伤均有较高诊断价值(AUC=0.921、0.836,P<0.05),其截断值分别为14.30 mg/L、15.88 mg/g。结论:病程、高血压、血糖控制情况可能影响T2DM肾病发生发展,UmAlb、UACR均对T2DM肾病患者肾脏损伤判断有利,可为临床诊断提供依据。
Objective:To explore the relationship between urine microalbumin(UmAlb),urine creatinine(UCr)and its ratio(UACR)and kidney damage in patients with type 2 diabetes mellitus(T2DM)nephropathy.Method:The clinical data of 73 T2DM nephropathy patients and 51 T2DM patients in our hospital were retrospectively analyzed.73 T2DM nephropathy patients were set as the study group,and were divided into the mild kidney damage group(46 cases)and the moderate kidney damage group(27 cases)according to 24 h urinary albumin excretion rate(UAER).Fifty-one T2DM patients were set as the control group.The baseline data and levels of UmAlb,UCr and UACR were compared among the three groups.The correlation between UmAlb,UCr,UACR and UAER was evaluated,and the receiver operating characteristic curve(ROC curve)was used to evaluate the diagnostic value of UmAlb and UACR on moderate kidney damage in T2DM nephropathy.Result:There were no statistically significant differences among the three groups in terms of gender,age,body mass index,smoking history and drinking history(P>0.05).There were statistically significant differences in the disease course of T2DM,prevalence rate of hypertension and levels of FPG and HbA1c among the three groups(P<0.05).The levels of UmAlb and UACR in the moderate kidney damage group were significantly higher than those in the mild kidney damage group and the control group(P<0.05),and the mild kidney damage group was higher than the control group,the differences were statistically significant(P<0.05).The level of UCr in the control group was lower than that in the moderate kidney damage group and the mild kidney damage group(P<0.05),but there was no significant difference between the moderate kidney damage group and the mild kidney damage group(P>0.05).Pearson correlation analysis showed that levels of UmAlb and UACR of patients with T2DM nephropathy were significantly positively correlated with UAER level(r=0.427,0.361,P<0.05),but there was no significant correlation between the level of UCR and the level of UAER(r=0.214,P>0.05).ROC curve showed that the levels of UmAlb and UACR had high diagnostic value on moderate kidney damage in T2DM nephropathy(AUC=0.921,0.836,P<0.05),and their cut-off values were 14.30 mg/L and 15.88 mg/g,respectively.Conclusion:The disease course,hypertension and blood glucose control may affect the occurrence and development of T2DM nephropathy.UmAlb and UACR are both beneficial to the judgment of kidney damage in patients with T2DM nephropathy,and can provide the basis for clinical diagnosis.
作者
钟丽娜
杨军
何伟
喻晨
ZHONG Lina;YANG Jun;HE Wei;YU Chen(Dangyang People’s Hospital,Dangyang 444100,China;不详)
出处
《中外医学研究》
2021年第29期68-72,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
糖尿病肾病
尿微量白蛋白
尿肌酐
尿微量白蛋白肌酐比值
尿白蛋白排泄率
Diabetic nephropathy
Urine microalbumin
Urine creatinine
Urine microalbumin creatinine ratio
Uurinary albumin excretion rate
