斑点尿白蛋白与肌酐比值与尿蛋白与肌酐比值诊断妊娠蛋白尿

Paroon Sanoonrat, N. Srisantiroj, M. Yanaranop
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引用次数: 0

摘要

目的:评价尿白蛋白/肌酐比(UACR)和尿蛋白/肌酐比(UPCR)与24小时尿蛋白(UP-24)采集的相关性,探讨这些参数对妊娠期显著性蛋白尿的诊断价值。本横断面研究于2015年11月至2016年4月期间对20-41周的临床怀疑有蛋白尿的孕妇进行前瞻性研究。随机取尿样检测UACR、UPCR, 24小时取尿样检测蛋白和肌酐。结果:共对115例孕妇进行了评估。以UP-24为参比标准,39例(33.9%)出现明显蛋白尿。UACR与UP-24的相关性高于UPCR (r分别为0.884和0.834)。UACR和UPCR的受试者特征曲线下面积(ROC-AUC)为96.6% (95%CI;93.8-99.9)和94.5% (95%CI;分别为90.4 - -98.6)。UACR对显著蛋白尿的诊断阈值为42 mg/g。(敏感性94.9%,特异性86.8%),而UPCR截止值为0.26(敏感性87.2%,特异性90.8%)。根据产妇年龄调整的现场UACR预测UP-24的ROC-AUC最高,为97.4% (95%CI;95.1-99.6),敏感性为94.9%,特异性为90.8%。结论:斑点UACR与UP-24的相关性优于UPCR。根据产妇年龄调整的Spot UACR用于预测UP-24,产生了良好的诊断性能,与临床评估和尿液收集时间或潜在疾病无关。
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Spot Urine Albumin to Creatinine Ratio versus Urine Protein to Creatinine Ratio for the Diagnosis of Proteinuria in Pregnancy
Objective: To evaluate the correlation of the spot urine albumin to creatinine ratio (UACR) and the urine protein to creatinine ratio (UPCR) with 24-hour urine protein (UP-24) collection and to explore the diagnostic performances of these parameters for detecting significant proteinuria in pregnancy Materials and methods: This cross-sectional study was conducted on pregnant women at gestational ages 20-41 weeks who had clinically suspected proteinuria and were prospectively enrolled from November 2015 and April 2016. Random urine samples for UACR, UPCR and 24-hour urine collection for protein and creatinine were examined. Results: A total of 115 pregnant women were evaluated. Using UP-24 as the reference standard, significant proteinuria was identified in 39 cases (33.9%). UACR had a higher level of correlation than UPCR with UP-24 ( r = 0.884 and 0.834, respectively). The areas under the receiver characteristics curves (ROC-AUC) of UACR and UPCR were 96.6% (95%CI; 93.8-99.9) and 94.5% (95%CI; 90.4-98.6), respectively. The diagnostic threshold of UACR for significant proteinuria was 42 mg/g. (94.9% sensitivity and 86.8% specificity), whereas the UPCR cutoff value was 0.26, (87.2% sensitivity and 90.8% specificity). Predicted UP-24 using spot UACR adjusted by maternal age had the highest ROC-AUC of 97.4% (95%CI; 95.1-99.6), with a sensitivity of 94.9% and a specificity of 90.8%. Conclusion: Spot UACR showed better correlation with UP-24 than UPCR. Spot UACR adjusted for maternal age was used to predict UP-24, yielding a good diagnostic performance that was not associated with the time of clinical assessment and urine collection or with underlying diseases.
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来源期刊
Thai Journal of Obstetrics and Gynaecology
Thai Journal of Obstetrics and Gynaecology Medicine-Obstetrics and Gynecology
CiteScore
0.40
自引率
0.00%
发文量
3
审稿时长
24 weeks
期刊最新文献
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