首页|基于广义估计方程评估尿液混匀程度对慢性肾脏病患者24 h尿蛋白定量的影响

基于广义估计方程评估尿液混匀程度对慢性肾脏病患者24 h尿蛋白定量的影响

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  • 国家科技期刊平台
  • NETL
  • NSTL
  • 万方数据
目的 探讨尿液标本的混匀程度对慢性肾脏病(chronic kidney disease,CKD)患者24 h尿蛋白定量(24-hour urinary total protein,24 h UTP)的影响.方法 选择2023年10月1日至2023年12月31日在复旦大学附属中山医院须完善24 h UTP的住院CKD患者30例.使用5 L集尿桶留取患者24 h尿液.尿液留取完成后,静置1 h,按体积分成上、中、下三等份,并分别取样,定义为直接采样组;采用磁力搅棒器充分混匀尿液标本,再次按上述三等分方法取样,定义为混匀采样组.采用广义估计方程比较混匀操作前后和不同采样位置的尿蛋白浓度差异.结果 广义估计方程统计结果显示,控制变量"采样位置"后,直接采样组和混匀采样组的尿蛋白浓度差异无统计学意义;控制变量"混匀方式"后,不同采样位置的尿液蛋白浓度差异无统计学意义.校正年龄、性别、估算肾小球滤过率(estimated glomerular filtration rate,eGFR)等协变量后,控制变量"采样位置"或"混匀方式"后,两采样组尿蛋白浓度或不同采样位置的尿蛋白浓度差异均无统计学意义.结论 规范留取的24 h尿液中尿蛋白分布相对均匀.总尿液采集完成后,1 h内可直接从原尿液任意层面提取临检标本,该标本的尿蛋白浓度乘以尿量可反映24 h UTP.
Effect of urine mixing degree on 24-hour urinary total protein in patients with chronic kidney disease based on generalized estimating equation
Objective To explore the effect of urine mixing degree on 24-hour urinary total protein(24 h UTP)in patients with chronic kidney disease(CKD).Methods From October 1,2023 to December 31,2023,30 hospitalized patients who needed to complete 24 h UTP testing in Zhongshan Hospital,Fudan University were selected.A 5 L unified container was used to collect urine for 24 hours.After collection and one hour's standing,the urine sample was divided into upper,middle,and lower equal parts according to volume,which was defined as direct-sampling group.Then,the urine samples were fully mixed with a magnetic stirrer and sampled again according to the above-mentioned three-equal sampling method,which was defined as mixed-sampling group.The generalized estimating equation was used to compare the urinary protein concentration before and after mixing and at different sampling location.Results The results of generalized estimating equation showed that after controlling the variable"sampling position",there was no significant difference in urinary protein concentration between the direct-sampling group and the mixed-sampling group.After controlling the variable"mixing method",there was still no significant difference in urinary protein concentration at different sampling positions.After adjusting the covariates such as age,gender,and estimated glomerular filtration rate(eGFR),the results were consistent.Conclusions With standard protocol,the entire 24-hour urine sample is a relatively even-distributed solution.After the total urine collection is completed,the temporary sample can be directly extracted from any level of the original urine within 1 hour,and the urine protein concentration of the sample multiplied by the urine volume can reflect the 24 h UTR.

chronic kidney disease24-hour urinary total proteingeneralized estimating equationmixing methodsampling location

邱珊芳、吴薇薇、李阳、方艺、焦晓燕、邵文琦、赵栓、滕杰、蔡洁茹、丁小强

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复旦大学附属中山医院肾内科,上海市肾病与透析研究所,上海肾脏疾病临床医学中心,上海市肾脏疾病与血液净化重点实验室,上海市血液透析质量控制中心,上海 200032

复旦大学附属中山医院厦门医院肾内科,厦门 361015

复旦大学附属中山医院护理部,上海 200032

复旦大学附属中山医院检验科,上海 200032

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慢性肾脏病 24h尿蛋白定量 广义估计方程 混匀方式 采样位置

国家自然科学基金福建省卫生健康科技计划项目福建省2023年省级临床重点专科建设项目上海市肾脏疾病与血液净化重点实验室上海市肾脏疾病临床医学研究中心

822707192022QNB01920DZ227160022MC1940100

2024

10.12025/j.issn.1008-6358.2024.20240340

中国临床医学
复旦大学附属中山医院

中国临床医学

CSTPCD
影响因子：1.002
ISSN：1008-6358
年,卷(期)：2024.31(3)
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