Bouhanick B, Berrut G, Chameau A M, Hallar M, Bled F, Chevet B, Vergely J, Rohmer V, Fressinaud P, Marre M
Unité de Diabétologie, Centre Hospitalier Régional et Universitaire, Angers, France.
Diabete Metab. 1992 Jan-Feb;18(1):54-8.
The predictive value of random urine sample during outpatient visit to predict persistent microalbuminuria was studied in 76 Type 1, insulin-dependent diabetic subjects, 61 Type 2, non-insulin-dependent diabetic subjects, and 72 Type 2, insulin-treated diabetic subjects. Seventy-six patients attended outpatient clinic during morning, and 133 during afternoon. Microalbuminuria was suspected if Urinary Albumin Excretion (UAE) exceeded 20 mg/l. All patients were hospitalized within 6 months following outpatient visit, and persistent microalbuminuria was assessed then if UAE was between 30 and 300 mg/24 h on 2-3 occasions in 3 urines samples. Of these 209 subjects eighty-three were also screened with Microbumintest (Ames-Bayer), a semi-quantitative method. Among the 209 subjects, 71 were positive both for microalbuminuria during outpatient visit and a persistent microalbuminuria during hospitalization: sensitivity 91.0%, specificity 83.2%, concordance 86.1%, and positive predictive value 76.3% (chi-squared test: 191; p less than 10(-4)). Data were not different for subjects examined on morning, or on afternoon. Among the 83 subjects also screened with Microbumintest, 22 displayed both a positive reaction and a persistent microalbuminuria: sensitivity 76%, specificity 81%, concordance 80%, and positive predictive value 69% (chi-squared test: 126; p less than 10(-4)). Both types of screening appeared equally effective during outpatient visit. Hence, a persistent microalbuminuria can be predicted during an outpatient visit in a diabetic clinic.
在76名1型胰岛素依赖型糖尿病患者、61名2型非胰岛素依赖型糖尿病患者和72名接受胰岛素治疗的2型糖尿病患者中，研究了门诊随机尿样预测持续性微量白蛋白尿的价值。76名患者在上午就诊，133名在下午就诊。如果尿白蛋白排泄量（UAE）超过20mg/L，则怀疑有微量白蛋白尿。所有患者在门诊就诊后6个月内住院，然后如果在3份尿样中2-3次检测UAE在30至300mg/24小时之间，则评估持续性微量白蛋白尿。在这209名受试者中，83名还采用半定量方法Microbumintest（Ames-Bayer）进行了筛查。在这209名受试者中，71名门诊微量白蛋白尿和住院期间持续性微量白蛋白尿均呈阳性：敏感性91.0%，特异性83.2%，一致性86.1%，阳性预测值76.3%（卡方检验：191；p<10^(-4)）。上午或下午检查的受试者数据无差异。在83名也采用Microbumintest进行筛查的受试者中，22名反应阳性且有持续性微量白蛋白尿：敏感性76%，特异性81%，一致性80%，阳性预测值69%（卡方检验：126；p<10^(-4)）。两种筛查在门诊就诊期间似乎同样有效。因此，在糖尿病门诊就诊期间可以预测持续性微量白蛋白尿。
