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目的比较尿蛋白的3种评价方法对于糖尿病性肾脏疾病(DKD)临床诊断的敏感性和特异性。方法对349例2型糖尿病患者进行24小时尿总蛋白(UTP)、尿白蛋白排泄率(UAER)、尿白蛋白/肌酐比值(ACR)测定及眼底检查,行工作特征曲线(ROC)分析,并观察3种方法与视网膜病变(DR)的相关性。结果ACR的ROC曲线下面积(AUC)是0.71,大于UAER的0.61和UTP的0.61(P<0.01),ACR诊断DKD的敏感性是68.42%(男)、60.0%(女),特异性是71.7%(男)、73.73%(女),均高于UTP和UAER。ROC曲线得出的UAER最佳临界点是54.95 μg/min。ACR-DR相关系数r为0.43,高于UTP-DR、UAER-DR的相关系数。结论初步研究显示ACR对于DKD诊断的准确性高于UTP和UAER,且ACR的敏感性和特异性高。
Objective To compare the sensitivity and specificity of three evaluation methods for urinary protein in the clinical diagnosis of diabetic nephropathy (DKD). Methods 249 urinary total protein (UTP), urinary albumin excretion rate (UAER), urinary albumin / creatinine ratio (ACR) and fundus examination in 349 patients with type 2 diabetes mellitus were measured. The working characteristic curve (ROC) The relationship between the three methods and retinopathy (DR) was observed. Results The area under the ROC curve (AUC) was 0.71 for ACR, 0.61 for UAER and 0.61 for UTP (P <0.01). The sensitivity of ACR in diagnosing DKD was 68.42% (male), 60.0% (female) and 71.7 % (Male), 73.73% (female), were higher than UTP and UAER. The best critical point of UAER obtained by ROC curve is 54.95 μg / min. The correlation coefficient r of ACR-DR was 0.43, which was higher than the correlation coefficient of UTP-DR and UAER-DR. Conclusions Preliminary studies have shown that the accuracy of ACR in the diagnosis of DKD is higher than that of UTP and UAER, and the sensitivity and specificity of ACR are high.