Whittemore Jacqueline C, Miyoshi Zona, Jensen Wayne A, Radecki Steven V, Lappin Michael R
Veterinary Medical Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
J Am Vet Med Assoc. 2007 Apr 15;230(8):1165-9. doi: 10.2460/javma.230.8.1165.
To determine the diagnostic usefulness of semiquantitative and quantitative microalbuminuria assays and urine albumin-to-creatinine (UAC) ratio for detecting disease in cats.
Prospective study.
441 cats evaluated at a veterinary teaching hospital.
Urine samples from cats for which a complete medical record was available were included. Urine dipstick results, urine protein-to-creatinine ratios (cutoffs, 0.1 and 0.4), semiquantitative and quantitative microalbuminuria assay results (cutoff, 1 mg/dL), and UAC ratio values (cutoffs, 100 and 200 mg/g) were determined. Clinical diagnoses determined within 3 months of enrollment were recorded. Sensitivity and specificity were determined with disease status used as the standard. The influences of clinical diagnosis, sex, age, serum urea nitrogen and creatinine concentrations, blood pressure, bacterial urine culture results, rectal temperature, pyuria, hematuria, and bacteriuria were evaluated by means of logistic regression.
Of 441 cats that were eligible for inclusion, 40 were healthy and 401 had > or = 1 disease. Results of logistic regression indicated that significant associations existed for age, presence of disease, presence of urinary tract disease, azotemia, hematuria, and pyuria and results of 1 or both of the microalbuminuria assays.
Microalbuminuria was associated with underlying disease. Sensitivity and specificity of the microalbuminuria assays for detection of systemic disease were superior to those of other tests. Microalbuminuria testing in conjunction with other screening procedures may increase identification of occult disease. A prospective study evaluating the predictive values of screening tests with and without microalbuminuria determination is needed to validate this recommendation.
确定半定量和定量微量白蛋白尿检测以及尿白蛋白与肌酐（UAC）比值对猫疾病检测的诊断效用。
前瞻性研究。
在一家兽医教学医院评估的441只猫。
纳入有完整病历的猫的尿液样本。测定尿试纸条结果、尿蛋白与肌酐比值（临界值为0.1和0.4）、半定量和定量微量白蛋白尿检测结果（临界值为1mg/dL）以及UAC比值（临界值为100和200mg/g）。记录入组后3个月内确定的临床诊断。以疾病状态为标准确定敏感性和特异性。通过逻辑回归评估临床诊断、性别、年龄、血清尿素氮和肌酐浓度、血压、细菌尿培养结果、直肠温度、脓尿、血尿和菌尿的影响。
在441只符合纳入标准的猫中，40只为健康猫，401只患有≥1种疾病。逻辑回归结果表明，年龄、疾病存在、泌尿系统疾病存在、氮质血症、血尿和脓尿与1种或2种微量白蛋白尿检测结果之间存在显著关联。
微量白蛋白尿与潜在疾病相关。微量白蛋白尿检测对全身性疾病检测的敏感性和特异性优于其他检测。微量白蛋白尿检测与其他筛查程序相结合可能会增加隐匿性疾病的识别。需要进行一项前瞻性研究，评估有无微量白蛋白尿测定的筛查试验的预测价值，以验证这一建议。
