The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Minhang District, Shanghai, China.
World J Pediatr. 2010 May;6(2):148-53. doi: 10.1007/s12519-010-0023-4. Epub 2010 Feb 1.
Although 24-hour urinary copper excretion is valuable for diagnosis of Wilson's disease, accurate, timed collection entails practical difficulties. This study aimed to investigate the feasibility of morning urinary copper/creatinine or copper/zinc ratio as replacement parameter for diagnosing Wilson's disease.
Five random urinary samples collected during 24 hours from two inpatients were used to estimate the consistency of urinary copper/creatinine and copper/zinc ratios. The correlation of the ratios with 24-hour urinary copper excretion was studied in 15 patients with liver diseases. The diagnostic value of morning urinary copper/zinc ratio was further studied in 9 children with Wilson's disease and 22 children with other liver diseases.
The coefficients of variation of urinary copper/creatinine and copper/zinc ratios during 24 hours were 12.5% and 9.3% respectively. The morning urinary copper/creatinine ratio, copper/zinc ratio, and 24-hour urinary copper excretion were correlated well. The area under receiver-operating characteristic curve was comparable between the morning urinary copper/zinc ratio and 24-hour urinary copper excretion (0.983 vs. 0.977).
Morning urinary copper/zinc ratio seems to be a promising parameter in replacement of 24-hour urinary copper excretion for diagnosis of Wilson's disease.
虽然 24 小时尿铜排泄对于威尔逊病的诊断很有价值，但准确、定时采集尿液存在实际困难。本研究旨在探讨晨尿铜/肌酐或铜/锌比值作为诊断威尔逊病的替代参数的可行性。
从两名住院患者的 24 小时尿液中随机采集 5 个尿液样本，用于估计尿铜/肌酐和铜/锌比值的一致性。研究了 15 例肝病患者的比值与 24 小时尿铜排泄的相关性。进一步研究了 9 例威尔逊病患儿和 22 例其他肝病患儿的晨尿铜/锌比值的诊断价值。
24 小时内尿铜/肌酐和铜/锌比值的变异系数分别为 12.5%和 9.3%。晨尿铜/肌酐比值、铜/锌比值和 24 小时尿铜排泄呈良好相关。早晨尿铜/锌比值与 24 小时尿铜排泄的受试者工作特征曲线下面积相当（0.983 比 0.977）。
晨尿铜/锌比值似乎是一种有前途的参数，可以替代 24 小时尿铜排泄用于诊断威尔逊病。
