Kruseman A C, van den Berg B W, Degenaar C P, Wolfenbuttel B H
Department of Internal Medicine, University Hospital Maastricht, The Netherlands.
Horm Metab Res Suppl. 1992;26:71-5.
The value of Micro-Bumintest tablets and the albumin/creatinine ratio in first morning (FM) urine samples to screen for micro-albuminuria in diabetic patients was evaluated. The A/C ratio in FM urine was highly correlated with the urinary albumin excretion (UAE) rate in micrograms/min in timed overnight (0) urine (R = 0.95, p < 0.001). The sensitivity, specificity and positive and negative predictive values of an A/C ratio > 3.0 to predict micro-albuminuria defined as an UAE > 20 micrograms/min were 94, 92, 92 and 94% respectively. The day-to-day fluctuation of albumin excretion varied between 10 and 105%. The sensitivity, specificity and positive and negative predictive values of micro-bumintest tablet reactions on FM urine samples to predict an A/C ratio > 3.0 were 93, 59, 63 and 91% respectively. It is concluded that for screening of micro-albuminuria the A/C ratio in FM urine is as precise as timed 0 urine collection, but with more comfort for the patient. Micro-Bumintest tablets are useful as an initial screening test and will decrease the number of quantitative albumin measurements in the screening programme by about 30% if only urine samples with positive tablet test are selected for a further investigation. Because of considerable day-to-day fluctuation of urinary albumin excretion several urine samples should be investigated before presence of incipient diabetic nephropathy is assumed.
评估了微量白蛋白检测片及晨尿样本中白蛋白/肌酐比值在糖尿病患者微量白蛋白尿筛查中的价值。晨尿中的A/C比值与定时过夜尿（0点尿）中以微克/分钟计的尿白蛋白排泄率（UAE）高度相关（R = 0.95，p < 0.001）。A/C比值> 3.0用于预测定义为UAE> 20微克/分钟的微量白蛋白尿的敏感性、特异性、阳性预测值和阴性预测值分别为94%、92%、92%和94%。白蛋白排泄的日间波动在10%至105%之间。晨尿样本上微量白蛋白检测片反应预测A/C比值> 3.0的敏感性、特异性、阳性预测值和阴性预测值分别为93%、59%、63%和91%。结论是，对于微量白蛋白尿筛查，晨尿中的A/C比值与定时0点尿采集一样精确，但对患者来说更舒适。微量白蛋白检测片作为初始筛查试验很有用，如果仅选择检测片试验呈阳性的尿样本进行进一步检查，将使筛查程序中白蛋白定量测量的数量减少约30%。由于尿白蛋白排泄存在相当大的日间波动，在假定存在早期糖尿病肾病之前应检测多个尿样本。
