【摘要】 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^99mTC-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。更多还原

【Abstract】 Objective To investigate the relationship between urinary albumin to creatinine ratio （UACR） and glomerular filtration rate（GFR） in diabetic chronic kidney disease.Methods A total of 294 diabetic patients were enrolled.The glomerular filtration rate was measured by ^99mTC-DTPA renal scintigraphy.We measured urine albumin and creatinine,and calculated UACR and then analyzed the relation between UACR and GFR.Results（1）There were 59 patients who had low GFR[GFR<60 ml ?min^-1?（1.73m）^-2],including 15 patients（9.6%） with normoalbuminuria,23 patients（25.3%） with microalbuminuria and 21 patients（45.7%） with macroalbuminuria.（2）The sensitivity and specificity in patients diagnosed as chronic kidney disease were 88.9%and 59.3%based on only UACR,were 94.4% and 54.3%based on combination of UACR and GFR,and were 81%and 89%based on only GFR, respectively.Conclusion A considerable proportion in diabetic patients without albuminuria may have renal impairment.The combination of UACR and GFR may enhance the capability of diagnosis of chronic kidney disease.更多还原