Poulsen P L, Hansen B, Amby T, Terkelsen T, Mogensen C E
Medical Department M, Kommunehospitalet, University Hospital, Aarhus, Denmark.
Diabete Metab. 1992 Sep-Oct;18(5):395-400.
A dipstick test for microalbuminuria was compared with urinary albumin excretion and urinary albumin concentration. Elevated urinary albumin excretion was defined as > 30 mg/24 h, elevated urinary albumin concentration in early morning urine as = > 20 mg/l and sticks = > 20 mg/l were considered positive. 1,071 samples with urinary albumin concentration 20-200 mg/l from 258 diabetic subjects were evaluated in three settings: I. 3 trained nurses testing samples from day-clinic diabetic patients. Sticks v.s. urinary albumin excretion sensitivity 86%, specificity 97%, predictive value of negative test 97%, correlation coefficient 0.79. Values for same setting but v.s. urinary albumin concentration were almost identical. II. 1 laboratory technician testing not-hospitalised diabetic patients: Sticks v.s. urinary albumin concentration: sensitivity 91%, specificity 85%, predictive value of negative test 95%, correlation coefficient 0.82. III. 58 general practitioners testing not-hospitalized diabetic patients: Sticks v.s. urinary albumin concentration: sensitivity 66%, specificity 92%, predictive value of negative test 83%, correlation coefficient 0.70.
In the hands of trained nurses and laboratory technician the Micral-Test showed good correlation with urinary albumin excretion and urinary albumin concentration for day-clinic and not-hospitalized patients and can be recommended as a screening tool. General practitioners obtained a lower sensitivity probably due to lack of experience and incorrect handling of the sticks leading to systematical errors. Training in the use of the stick must be emphasized, since under such circumstances the results are satisfactory.
对微量白蛋白尿的试纸条检测与尿白蛋白排泄量及尿白蛋白浓度进行了比较。尿白蛋白排泄量升高定义为>30mg/24小时，晨尿中尿白蛋白浓度升高定义为≥20mg/L，试纸条检测结果≥20mg/L被视为阳性。对来自258名糖尿病患者的1071份尿白蛋白浓度在20 - 200mg/L之间的样本在三种情况下进行了评估：I. 3名经过培训的护士检测日间门诊糖尿病患者的样本。试纸条检测与尿白蛋白排泄量相比：灵敏度86%，特异性97%，阴性检测预测值97%，相关系数0.79。同一情况下与尿白蛋白浓度相比的值几乎相同。II. 1名实验室技术人员检测未住院的糖尿病患者：试纸条检测与尿白蛋白浓度相比：灵敏度91%，特异性85%，阴性检测预测值95%，相关系数0.82。III. 58名全科医生检测未住院的糖尿病患者：试纸条检测与尿白蛋白浓度相比：灵敏度66%，特异性92%，阴性检测预测值83%，相关系数0.70。
在经过培训的护士和实验室技术人员手中，Micral检测试纸条对于日间门诊和未住院患者的尿白蛋白排泄量和尿白蛋白浓度显示出良好的相关性，可推荐作为一种筛查工具。全科医生获得的灵敏度较低可能是由于缺乏经验以及对试纸条操作不当导致系统误差。必须强调对试纸条使用的培训，因为在这种情况下结果是令人满意的。
