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双语推荐：尿白蛋白/尿肌酐比值

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目的 检测急性脑梗死患者的尿白蛋白/尿肌酐比值与尿白蛋白水平,探讨其与NEW-TOAST分型的关系. 方法 收集佛山市第一人民医院神经内科自2011年3月至2012年3月收治的168例急性脑梗死患者的临床资料,另取周期体检中心体检的45例健康志愿者作为正常对照组;检测其尿白蛋白/尿肌酐比值与24 h尿白蛋白水平,并分析其相关性;比较按NEW-TOAST不同分型的脑梗死患者间及其与对照组间的尿白蛋白/尿肌酐比值与24 h尿微量白蛋白水平的差异,以及患者神经功能缺损情况(NIHSS评分)与尿白蛋白/尿肌酐比值的关系. 结果 急性脑梗死患者中尿白蛋白/尿肌酐比值与24 h尿白蛋白存在正相关关系(r=0.301,P=0.001);NEW-TOAST分型的各亚型中,大动脉粥样硬化性卒中组及小动脉闭塞性卒中组的尿白蛋白/尿肌酐比值和24 h尿白蛋白水平均明显高于对照组,差异有统计学意义(P＜0.05).脑梗死患者NIHSS评分与尿白蛋白/尿肌酐比值呈正相关关系(r=0.215,P=0.001). 结论 急性脑梗死与肾脏疾病之间存在密切关系,尿蛋白/尿肌酐比值与24h尿微量蛋白效价相当,均可成为急性脑梗死的预测及预后指标.
Objective To detect the urinary albumin level and urinary albumin/urine creatinine ratio in patients with acute cerebral infarction and explore their relations with NEW-TOAST typing.Methods One hundred and sixty-eight patients with acute cerebral infarction,admitted to our hospital from March 2011 to March 201,were chosen in our study; and other 45 healthy subjects were used as controls; according to NEW-TOAST typing,the patients were divided into different subgroups.Their clinical data were retrospectively analyzed; the 24 hour urinary albumin level and urinary albumin/urine creatinine ratio were detected and their relation was analyzed between patient group and controls,and between patients of different subtypes; besides,the correlation of neurologic impairment (NIHSS) scores with urinary albumin/urine creatinine ratio was analyzed.Results The 24 hour urinary albumin level and urinary albumin/urine creatinine ratio was positively correlated (r=0.301,P=0.001); according to the NEW-TOA

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目的：通过观察门诊患者24 h尿蛋白（24hUp）、尿微量白蛋白（24hmAlb）与随机尿和晨尿尿蛋白/肌酐比值（Up/Ucr）及尿微量白蛋白/肌酐比值（UmAlb/Ucr）的相关性，来探讨采用随机尿或晨尿Up/Ucr与UmAlb/Ucr代替24hUp和24hmAlb用于肾病早期损伤筛查的可行性。方法：收集104例患者24 h尿、晨尿、随机尿尿液标本，尿蛋白测定采用免疫比浊法，尿微量白蛋白采用透射免疫比浊法，尿肌酐测定采用酶比色法。结果：晨尿Up/Ucr比值与24hUp和晨尿UmAlb/Ucr比值与24hmAlb具有良好的相关性，相关系数分别为r=0.943和0.771；晨尿UmAlb/Ucr和Up/Ucr比值有较高的诊断敏感度和阴性预测值；晨尿和随机尿液Up/Ucr之间差异无统计学意义（P＞0.05）。结论：随机尿和晨尿Up/Ucr比值与24hUp有良好的相关性，且具有很高的灵敏度，可以用随机尿或晨尿Up/Ucr代替24hUp用于门诊患者和健康查体人群的早期肾损伤程度的筛查和监测。
Objective To study the correlation between 24-hour urinary protein excretion(24hUp),24-hour urinary albumin(24hmAlb) and spot urine(Including the morning urine and random urine) protein/creatinine ratio(Up/Ucr),albumin/creatinine ratio(UmAlb/Ucr) in outpatients,and to evaluate the clinical application of Up/Ucr and UmAlb/Ucr in spot urine samples as a predictor of 24hUp and 24hmAlb in Nephropathy injury screening.Methods 24-hour urine collection,first morning and random urine specimens of each patients were collected from 104 outpatients. The urinary protein was tested by immunoturbidimetry,urinary albumin was tested by immune transmission turbidity and urinary creatinine was tested by the enzyme colorimetry method.Results There was a high significant correlation between Up/Ucr in first morning urine specimens and 24hUp(also UmAlb/Ucr and 24hmAlb),r=0.943,0.771,respectively.There was a high sensitivity and negative predictive value in first morning urine specimens.There were no signifi

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对435例2型糖尿病患者的临床资料进行回顾性分析,发现糖尿病肾病患者血清载脂蛋白E水平显著高于无糖尿病肾病者[50.4(40.8,65.9)对46.2(38.6,56.8) mg/L,P＜0.01],高载脂蛋白E组尿白蛋白/肌酐比值明显高于低载脂蛋白E组(P＜0.01),载脂蛋白E是尿白蛋白/肌酐比值的独立影响因素(β=0.14,P＜0.05).
[Summary] This retrospective analysis showed that the level of apolipoprotein E was significantly higher in diabetic nephropathy group compared with normal albuminuria group [50.4 (40.8,65.9) vs 46.2 (38.6,56.8)mg/L,P＜0.01].Difference in urinary albumin to creatinine ratio (ACR) among the groups based on the tertile of apolipoprotein E were significant (P＜ 0.01).Multiple linear regression analysis demonstrated that apolipoprotein E was independently associated with ACR (β =0.14,P＜0.05).

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目的：研究某部干部血尿酸及肾脏排泄尿酸变化的影响因素，查找尿酸升高的可能危险因素，为控制尿酸提供指导依据。方法利用年度干部体检对某部参加体检的非痛风和尿酸未受明确因素影响的1096人进行问卷调查，及血生化等检查，并计算体质指数、尿白蛋白肌酐比、尿酸-肌酐廓清率比值。以男性血尿酸＞420μmol/L（7.0 mg/dL）、女性血尿酸＞357μmol/L（6.0 mg/dL）为高尿酸血症组，余为非高尿酸血症组；以尿酸-肌酐廓清率比值由低到高分为尿酸低排组、混合组和尿酸高排组。汇总数据后进行统计学分析。结果男性血尿酸明显高于女性[（330.9±69.4）mmol/L 与（249.4±55.2）mmol/L）]；高尿酸血症患病率男性与女性无明显差别。高尿酸血症组体质指数、收缩压、舒张压、三酰甘油、血肌酐、尿素氮、高敏 C 反应蛋白、同型半胱氨酸、尿白蛋白肌酐比、腰围、臀围均明显高于非高尿酸血症组，而高密度脂蛋白、尿酸-肌酐廓清率比值明显低于非高尿酸血症组。高尿酸血症与体质指数、三酰甘油、血肌酐、高敏 C 反应蛋白、尿白蛋白肌酐比、尿酸-肌酐廓清率比值密切相关，其中尿酸-肌酐廓清率比值、三酰甘油、体质指数为重要影响因素。血尿酸与三酰甘油、体质指数、腰围、臀围、舒张压
Objective To study the influencing factors of serum uric acid levels and uric acid excretion in the officers at a military unit, in order to search the potential risk factors corre-sponding to the elevation of serum uric acid, and provide guidance to the control of uric acid levels. Methods In 1 096 cases, a questionnaire survey was provided for the retired officers in the military unit.Based on predefined inclusion and exclusion criteria, healthy officers or officers who took no drugs affecting uric acid metabolism were selected.Body mass index (BMI), urinary albumin creati-nine ratio (ACR) and uric acid to creatinine clearance rate (Cua/Ccr) were measured, and the data was analyzed.Results Men had higher serum uric acid levels compared with women [(330.9± 69.4)mmol/L vs.(249.4±55.2) mmol/L].There was no significant difference in the prevalence of hyperuricemia (HUA) between men and women (8.7% vs.5.6%).HUA group had higher BMI, systolic blood pressure, diastolic blood pre

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目的 探讨糖化血红蛋白(HbA1c)和尿微量白蛋白/肌酐比值(UACR)在糖尿病肾病诊断中的临床价值.方法 检测67例糖尿病肾病、87例2型糖尿病非肾病以及120例健康对照组血糖化血红蛋白以及尿微量白蛋白、尿肌酐值.统计分析不同病程患者的糖化血红蛋白以及尿微量白蛋白/尿肌酐比值结果.通过诊断试验评估分析检测HbA1c和UACR对糖尿病肾病诊断的临床价值.结果 HbA1c和UACR水平和糖尿病肾病病程有很密切关系,随病程的延长呈逐步上升趋势.糖尿病肾病组UACR水平与正常组以及2型糖尿病非肾病组相比均具有统计学差异(P＜0.01).诊断试验评估发现单独检测UACR比单独检测HbA1c对糖尿病肾病的诊断能力强(HbA1c阳性似然比和阴性似然比分别为1.17、0.82;UACR阳性似然比和阴性似然比分别为6.12、0.04).结论 HbA1c和UACR联合检测可以提高糖尿病肾病的诊断价值,使糖尿病肾病的早期诊断更加稳定可靠.
Objective To investigate the value of the glycosylated haemoglobin (HbA1c) and urinary albumin to creatinine ratio (UACR) in the diagnosis of diabetic kidney disease.Methods HbA1c,microalbuminuria and creatinine were detected in 67 diabetic kidney patients,87 type 2 diabetic non-nephropathy cases and 120 health subjects.The value of HbA1c and UACR in different course of diabetic kidney and type 2 diabetic non-nephropathy were analyzed.Results The HbA1c and UACR had a rising trend according to the development of diabetic kidney.UACR level of diabetic nephropathy group showed statistical significant difference compared with those of normal group and type 2 diabetic non-nephropathy group (P ＜ 0.01).Single diagnosis of UACR had higher diagnosis ability than those of HbA1c during the diagnostic test (positive likelihood ratio and negative likelihood ratio in HbA1c were 1.17 and 0.82; positive likelihood ratio and negative likelihood ratio in UACR were 6.12 and 0.04).Conclusion Co

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目的 观察乙酰肝素酶对脓毒症肾小球内皮细胞糖萼的影响,并探讨其预防措施.方法 C57BL/6小鼠给予脂多糖(LPS)或肿瘤坏死因子α(TNF-α)腹腔注射,1h后处死,镧示踪后透射电镜观察肾小球内皮细胞糖萼变化,Western印迹检测肾皮质的乙酰肝素酶蛋白表达;人肾小球内皮细胞用TNF-α作用1h,Western印迹检测乙酰肝素酶的活化蛋白变化.小鼠注射LPS同时给予肝素钠和肝素酶Ⅲ,电镜观察肾小球内皮细胞糖萼的变化;留取小鼠24 h尿液,检测各组尿白蛋白和尿肌酐,计算尿白蛋白-肌酐比值,进行比较.结果 镧示踪透射电镜显示,LPS组和TNF-α组肾小球内皮细胞糖萼均降解,而足细胞糖萼完整.小鼠注射LPS后1h开始,肾皮质乙酰肝素酶蛋白表达显著增高(P＜0.01).TNF-α刺激人肾小球内皮细胞后乙酰肝素酶活化增加(P＜0.05).小鼠注射LPS同时给予肝素钠抑制乙酰肝素酶,肾小球内皮细胞糖萼完整,尿白蛋白-肌酐比值显著低于LPS组(P＜0.05);同时给予肝素酶Ⅲ使肾小球内皮细胞糖萼降解,尿蛋白-肌酐比值无改善,显著高于对照组(P＜0.01).结论 脓毒症初期,TNF-α使肾小球内皮细胞的乙酰肝素酶表达和活化增加,肾小球内皮细胞糖萼降解,发生蛋白尿;抑制乙酰肝素酶能保护肾小球内皮细胞糖萼,减少尿蛋白.
Objective To observe the impact of heparanase on glomerular endothelium glycocalyx during sepsis and to investigate the prevention of glycocalyx injury.Methods C57/BL6 mice were injected with lipopolysaccharide (LPS) or tumor necrosis factor-α(TNF-o) and sacrificed one hour later.Glomerular endothelium glycocalyx traced with lanthanum was observed by transmission electron microscope(TEM).Western blotting was used to observe heparanse protein expression of renal cortex tissue.Human renal glomerular endothelial cells (HRGECs) were stimulated with TNF-α and active heparanase protien expression was detected by Western blotting.Mice were administrated with heparin sodium or heparinase Ⅲ and renal endothelium glycocalyx was observed by TEM.Urine during twenty-four hours was collected to measure urinary albumin and creatinine.The ratio of albumin to creatinine was calculated and compared among groups.Results The glomerular endothelium glycocalyx of LPS group and TNF-α group was

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目的：探讨硒酵母片（西维尔）对肾功能正常的2型糖尿病肾病患者尿微量白蛋白的影响。方法：以晨尿的尿微量白蛋白/肌酐比值定义微量白蛋白尿（microalbuminuria,UMALB）,UMALB〈30μg/g Cr为无微量白蛋白尿,UMALB≥30mg/g Cr为微量白蛋白尿,连续2次可以诊断为糖尿病肾病。以肾小球滤过率估算值（Estimated glomerular filtration rate,e GFR）作为肾功能的评价指标（e GFR 80-100m L/min·1.73m^2为肾功能正常）,将67例肾功能正常的2型糖尿病肾病患者分为西维尔观察组29例和对照组38例,用t检验分析比较了治疗前后两组间的临床资料和实验室检查,P〈0.05为差异有统计学意义。结果：治疗前,两组尿微量白蛋白无显著性差异,治疗后6个月,观察组的尿微量白蛋白（326.9±101.7）mg/g Cr低于对照组（349.6±115.4）mg/g Cr,差异有统计学意义（P〈0.05）。结论：西维尔可降低2型糖尿病肾病患者尿微量白蛋白水平,延缓2型糖尿病患者糖尿病肾病的进展。
Objective: To discuss the effects of selenium yeast tablets on microalbuminuria of type 2 diabetes with normoal eGFR. Methods: Microalbuminuria above 30mg/gCr was defined as abnormal. The patients whoes microalbumin-uria were abnaomal for twice continuously with type 2 diabetes were diagnosed as diabetic nephropathy, the renal functions were estimated with the estimated glomerular filtration rate(eGFR, 80-100ml/min·1.73m2 is normal) and clinical data were recorded. The patients with diabetic nephropathy whose eGFR were normal were divided into the treatment group (n=29) with selenium yeast tablets and control group (n=38).Then the microalbuminuria and other clinical data were compared by T-test with SPSS19.0. Results: There was not distinct difference betweet the two groups at the beginning. The microalbu-minuria in the treatment group was lower than that of in the control group(P=0.023) after treatment. Conclusions: The se-lenium yeast tablets can reduce the microalbuminuri

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目的：观察复方血栓通胶囊治疗早期糖尿病肾病的临床疗效。方法收集2011年9月至2012年10月河南省商丘市第一人民医院内分泌科90例早期糖尿病肾病住院患者，按病例尾号将患者随机分为两组各45例。对照组予以糖尿病教育、控制血糖、控制血压、调节血脂等治疗；治疗组在对照组治疗基础上加用复方血栓通胶囊，3粒/次，3次/d。治疗12周后，比较两组治疗前后血糖、糖化血红蛋白、尿微量白蛋白、尿微量/肌酐比值的变化。结果①两组尿微量白蛋白、尿白蛋白/肌酐比较：两组治疗后尿微量白蛋白、尿微量肌酐比值[治疗组分别为(24.5±9.1)mg/L、(2.39±1.6)mg/mmol，对照组分别为(85.9±8.6)mg/L、(5.6±2.1)mg/mmol]均较同组治疗前[治疗组为(142.5±20.8)mg/L、(27.1±5.3)mg/mmol，对照组为(141.6±21.6)mg/L、(26.3±5.6)mg/mmol]明显降低(P＜0.01或0.05)，且治疗组疗效优于对照组(P＜0.05)。②两组FBG、2 hBG、HbA1c水平比较：治疗后两组FBG、2 hBG、HbA1c水平[治疗组分别为(5.58±1.57)mmol/L、(7.82±2.43)mmol/L、(7.01±1.22)%，对照组分别为(5.67±1.46)mmol/L、(7.71±2.59)mmol/L、(6.83±2.31)%]均较同组治疗前[治疗组分别为(8.69±1.59)mmol/L、(12.79±2.50)mmol/L
Objective To observe the clinical effect of early diabetic nephropathy treated with Fufang-Xueshuantong capsule. Methods 90 hospitalized patients from September 2011 to October 2012 with early diabetic nephropathy were recruited in Shangqiu First people''s hospital endocrinology of Henan Province. All patients were divided into two groups randomly, with 45 patients in each group. The control group was treated with diabetes education, blood glucose control, blood pressure control, and blood lipid regulation, while the treatment group was treated with Fufang-Xueshantong capsule on the basis of the control group. The change of blood glucose, HbA1c, urine microalbumin, and Ualb/Cr were measured before and 12 weeks after the treatment. Results ① Compared the urine microalbumin, Ualb/Cr of the two groups before and after treatment:the urine microalbumin, Ualb/Cr of the two groups after the treatment [Treatment group was(24.5±9.1)mg/L,(2.4± 1.6)mg/mmol, Control group was(85.9±8.

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目的：检测糖尿病伴有高白蛋白尿患者尿中βig-h3的含量，以及用尿中βig-h3含量评估糖尿病肾病严重程度的可行性。方法采用酶联免疫法（ELISA）测定173例2型糖尿病（T2DM）患者和103例年龄、体质量相当的健康成人的血和尿中βig-h3的含量。分析肾脏不同病变程度的T2MD患者（正常白蛋白尿92例，微量白蛋白尿49例，明显蛋白尿32例）尿中βig-h3的含量与尿肌酐值的比值。结果尿中βig-h3的含量与尿肌酐比值在T2MD患者的三个组（正常白蛋白尿者为101.7±9.28，微量白蛋白尿者为120.3±14.49，明显蛋白尿者为146.4±16.35）均明显高于正常对照组（64.7±7.13），P﹤0.01。尿中βig-h3和TGF-β的排泄率呈正相关，并且尿中βig-h3排泄率和白蛋白排泄率（AER）也呈正相关。结论 T2MD伴有肾病患者的尿中βig-h3含量明显增高，提示尿中ig-h3的含量可做为诊断糖尿病肾病的一项指标。
Objective To detect the urinary βig-h3 level in diabetic patients with elevated uri-nary albumin excretion,and the feasibility of urinaryβig-h3 as an index for evaluating the severity of dia-betic nephropathy. Methods Urinary and serum βig-h3 levels were detected by enzyme-linked immu-nosorbent assay( ELISA )in 173 patients with type 2 diabetic mellitus and 103 healthy control subjects with comparable age and weight. The ratio of urinary βig-h3 to creatinine was analyzed in patients with different degrees of nephropathy(92 cases of normal albuminuria,49 cases of microalbuminuria,32 cases of overt proteinuria). Results Theβig-h3 to creatinine ratio in urine was significantly elevated in all of the three groups of type 2 diabetics( which was 101. 7 ± 9. 28 in patients with normal albuminuria, 120. 3 ± 14. 49 in patients with microalbuminuria,146. 4 ± 16. 35 in patients with overt proteinuria)than that in control group( which was 64. 7 ± 7. 13 ),P﹤0. 01 . The excretion

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目的 探讨妊娠期高血压疾病孕妇随机尿中尿微量白蛋白/肌酐比值(UACR)与24 h尿蛋白定量之间的相关性.方法 选取2013年1-12月东莞市厚街医院收治的妊娠期高血压疾病孕妇143例,采用免疫比浊法检测孕妇的24h尿蛋白定量,采用自动生化分析仪检测UACR,再进行二者的相关性分析.结果 从妊娠期高血压到轻度子痫前期再到重度子痫前期孕妇UACR和24 h尿蛋白定量均逐渐升高,三组比较差异有统计学意义(P均＜0.05).UACR与24h尿蛋白定量呈密切正相关(r=0.898,P＜0.05).结论 随机UACR有望代替24 h尿蛋白定量评估子痫前期病情严重程度.
Objective To analyze the correlation between random urinary microalbumin/creatinine ratio and 24 h urinary protein excretion in women with hypertensive disorders complicating pregnancy.Methods There were 143 cases with hypertensive disorders complicating pregnancy from January to December in 2013.Twenty-four hours urinary protein excretion was measured by immunotnrbidimetric assay and microalbumin/creatinine ratio was determined by automatic analyzer.Results Urinary albumin/creatinine ratio and 24 h urinary protein increased gradually from pregnancy induced hypertension to mild and severe preeclampsia,with significant differences(P＜0.05).There was a strong correlation between the microalbumin/creatinine ratio and 24 h urine protein excretion (r=0.898,P＜0.05).Conclusion Microalbumin/ creatinine ratio may be used as a replacement for 24 h urinary protein excretion in assessment of preeclampsia.

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