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目的探讨尿白蛋白与肌酐比值(UACR)和肾小球滤过率(GFR)联合诊断在糖尿病肾脏病变评估中的临床意义。方法分析294例住院糖尿病患者的资料,行~(99m)TC-DTPA肾小球滤过率和UACR检查。结果正常白蛋白尿、微量白蛋白尿及大量白蛋白尿患者中分别有9.6%(15/157)、25.3%(23/91)、45.7%(21/46)出现了GFR的下降;以UACR为标准诊断糖尿病患者肾损害的灵敏度、特异度分别为88.9%、59.3%,以GFR为标准其灵敏度、特异度分别为80.6%、88.8%,而联合UACR与GFR诊断其灵敏度、特异度分别为94.4%、54.3%;结论UACR正常的糖尿病患者已有部分出现肾功能下降,联合GFR有助于更好地评价糖尿病患者的肾脏病变情况。
Objective To investigate the clinical significance of the combination of urinary albumin and creatinine ratio (UACR) and glomerular filtration rate (GFR) in the assessment of diabetic nephropathy. Methods The data of 294 inpatients with diabetes mellitus were analyzed. The glomerular filtration rate of ~ (99m) TC-DTPA and UACR were measured. Results The decrease of GFR was found in 9.6% (15/157), 25.3% (23/91) and 45.7% (21/46) of patients with normal albuminuria, microalbuminuria, and large albuminuria, respectively. UACR The sensitivity and specificity of these two methods were 88.9% and 59.3% respectively. The sensitivity and specificity of GFR were 80.6% and 88.8% respectively. The sensitivity and specificity of combined UACR and GFR were 94.4% and 54.3% .Conclusion Some patients with normal UACR have some renal dysfunction. Combined with GFR may help to better evaluate the renal disease in diabetic patients.