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| 高尿钙诊断方法探索 |
| The investigation of diagnostic method of hypercalciuria |
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| DOI：10.3969/j.issn.1006.7108.2018.01.008 |
| 中文关键词: 高尿钙 诊断 空腹1小时尿钙浓度 |
| 英文关键词:Hypercalciuria Diagnosis Fasting 1-hour urinary calcium concentration |
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| 中文摘要: |
| 目的 寻找替代24hUC诊断高尿钙的指标，尝试利用空腹1小时尿钙浓度（fasting 1-hour urinary calcium concentration ,1hUCa）与24小时尿量的乘积诊断高尿钙，探索其最佳诊断切点，并判断与24hUC相比，两种方法的一致性。方法 留取24小时尿及随后的空腹1小时尿标本，分别测定24小时平均尿钙浓度、清晨空腹1小时尿钙浓度，计量24小时尿量，计算24小时尿钙，行24小时平均尿钙浓度与1hUCa的相关性分析，以空腹1小时尿钙浓度与24小时尿量的乘积为诊断指标，行该值与24hUC的相关性分析，做ROC曲线寻找最佳诊断切点，并计算其敏感度、特异性、误诊率，采用Bland–Altman 绘图和数据分析，比较该诊断指标与24HUC的一致性。结果 清晨空腹1小时尿钙浓度*24小时尿量的乘积与24小时尿钙具有显著的相关性，以其诊断高尿钙时，将24HUC>350mg/d选取为诊断切点，所做ROC曲线，曲线下面积为0.993。其值选取10.969mmol/d为切点时，敏感度为100%，特异性为96%，误诊率20%。该诊断指标平均高于24HUC 2.545，95%一致性界限在-6.4和2.7之间。结论 由于敏感度和特异性好，误诊率低，一致性好，空腹1小时尿钙浓度与24小时尿量的乘积能代替24hUC作为高尿钙诊断指标。 |
| 英文摘要: |
| Objective To explore the method of using the product of fasting 1-hour urinary calcium concentration (1h UCa) and 24-hour urine output to replace 24 HUC, to find the best cut-off, and to judge the agreement. Methods 24-hour urine samples were collected. The 24-hour average urine calcium concentration, 1hUCa and 24-hour urine output were measured. The correlation between 24-hour average urine calcium concentration and 1h UCa was analyzed. The correlation between product of 1h UCa and 24 HUC was analyzed. ROC curve was drawn to find the cut-off point. The sensitivity, specificity, and misdiagnosis rate were evaluated. The agreement between there was judged with Bland–Altman analysis. Results The product of 1h UCa and 24-hour urine output was significantly correlated with 24 HUC. When 24 HUC>350mg/d was chosen as the cut-off point to draw ROC curve for the diagnosis of hypercalciuria, the area under the curve was 0.993. When 10.969 mmol/d was chosen, the sensitivity, specificity, and misdiagnosis rate were 100%, 96%, and 20%, respectively. The diagnosis indicator was 2.545 higher in average than 24hUC, with 95% agreement interval of -6.4 to 2.7. Conclusion Because of the good sensitivity, specificity, low misdiagnosis rate, and the good agreement, the product of 1h UCa and 24-hour urine output can replace 24 HUC to diagnose hypercalciuria. |
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