CN107918006A - A kind of measuring device and method of female urine sodium predicted value - Google Patents

A kind of measuring device and method of female urine sodium predicted value Download PDF

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CN107918006A
CN107918006A CN201711010002.9A CN201711010002A CN107918006A CN 107918006 A CN107918006 A CN 107918006A CN 201711010002 A CN201711010002 A CN 201711010002A CN 107918006 A CN107918006 A CN 107918006A
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sodium
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孙宁玲
王鸿懿
袁亦芳
牟建军
姜农
姜一农
孙跃民
徐新娟
商黔惠
初少莉
尹新华
王浩
袁洪
崔玉贤
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Peking University
Peking University Peoples Hospital
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    • GPHYSICS
    • G01MEASURING; TESTING
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    • G01N33/493Physical analysis of biological material of liquid biological material urine
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    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/70Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving creatine or creatinine

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Abstract

The present invention provides a kind of measuring device and method of 24h female urines sodium value, including urinating component amount detection unit, it is among the point urine drained in a period of regulation, and component amount included in test point urine, the component amount includes point urine sodium value, point urine potassium value and point urine creatinine value;And twenty-four-hour urine sodium predictor calculation unit, according to component amount, women twenty-four-hour urine sodium predicted value in calculating crowd included in a urine.The device of the invention can realize high-precision and time saving easily the measuring of women twenty-four-hour urine sodium value.

Description

A kind of measuring device and method of female urine sodium predicted value
Technical field
The invention belongs to field of medicaments, and in particular to a kind of measuring device for being used to assess women twenty-four-hour urine sodium predicted value And method.
Background technology
The excessive of salt intake can cause hypertension, and hypertension is coronary heart disease and the important risk factor of cerebral apoplexy, WHO The death of statistics, about 54% cerebral apoplexy and 47% ischemic heart disease is related with hypertension.And sodium intake and blood pressure Level is in notable positive correlation.The excessive intake of sodium salt can cause plasma volume increase blood pressure is increased, while the intake of high sodium salt Also it the sodium is deposited in vascular wall and is aggravated artery sclerosis and atherosis and occur, blood pressure is increased and macrovascular diseases event Occur (coronary heart disease and cerebral apoplexy).Hypertension becomes important global public health problem.China's survey data in 2002 is shown Show, in more than the 18 years old adult in China, Prevalence of Hypertension 18.8%.And limit the non-drug therapies such as salt, control blood pressure and It in target organ damage with having consequence.Many studies have shown thats are taken the photograph salt and are damaged with blood pressure, cardiovascular risk, target organ Evil is closely related.According to the current World Health Organization and China's hypertension prevention and control guidelines, intaking amount of sodium-salt should for each person every day No more than 6g, but situation up to standard is not very good, and China some areas are even more than 12g/d.
The method for speculating intaking amount of sodium-salt based on natruresis amount specifically includes twenty-four-hour urine sodium measurement, enuresis nocturna/urina sanguinis, point Urinate the urine sodium measurement of (including second of urine, random urine etc. from morning).Twenty-four-hour urine sodium measurement is most reliable at present and accurately square Method, but the acquisition time length of twenty-four-hour urine liquid, process is cumbersome, and inconvenience is brought to patient.In addition, individual daily salt is taken the photograph It is according to the different continually changing of diet to enter amount, only judges that its average salt takes in water by collecting single twenty-four-hour urine liquid Flat is inappropriate.Therefore, sodium content is estimated from simplify and improve the angle of popularity rate, urinated using test point Twenty-four-hour urine sodium value is then a kind of method of clinical demand.
At present, twenty-four-hour urine sodium is to assess the goldstandard that salt is taken in diet, but this method is relatively complicated, is not easy to carry out Patient examination or extensive epidemiology survey.Point urine method is simple and convenient as one of method of assessment twenty-four-hour urine sodium.At present The use of relatively broad point urine formula is Kawasaki formula, however, research finds that Kawasaki formula have significantly over-evaluated actual measurement Urinate sodium.Therefore simply and easily effective salt intake appraisal procedure is established, instructs government, scholar and crowd to carry out the limit salt of precision Extremely important, regrettably assesses the intake of salt there is presently no good method.
The content of the invention
For above-mentioned defect existing in the prior art, the object of the present invention is to provide one kind to be used for women in assessment crowd Urinate the measuring device and method of sodium predicted value;The measuring device is kit, can urinate sodium based on the point of women random urine sample Value, point urine potassium value and point urine creatinine value assessment female urine sodium predicted value.
To reach above-mentioned purpose, technical solution provided by the invention is as follows.
The measuring device of female urine sodium predicted value in a kind of crowd, including urine component amount detection unit, it is defined Among the point urine of excretion in period, component amount included in test point urine, the component amount includes point urine sodium value, point urine potassium value With a urine creatinine value;And twenty-four-hour urine sodium predictor calculation unit, according to component amount included in a urine, in calculating crowd Women twenty-four-hour urine sodium predicted value.
The measuring method of female urine sodium predicted value, comprises the following steps in a kind of crowd:Component amount calculation procedure in urine, Component included in test point urine among the point urine that component amount computing unit is drained in a period of the regulation in being urinated in the step Amount, the component amount include point urine sodium value, point urine potassium value and point urine creatinine value;And twenty-four-hour urine sodium value calculation procedure, at this By twenty-four-hour urine sodium predictor calculation unit in step, according to component amount included in a urine, women 24 in calculating crowd Hour urine sodium predicted value.
The twenty-four-hour urine sodium predictor calculation unit is calculated according to equation below:
24h urine sodium predicted value (mmol/d)=- 65.6155+2.7387 × ages (year) -0.0297 × age2(year2)+ 0.2685 × random urine sodium (mmol/l) -1.6453 × random urine sodium potassium ratio+275.175 × urine sodium creatinine ratio (mmol/mg)+ 1.1855 × weight (kg)
Urine sodium creatinine ratio (mmol/mg) is converted to random urine sodium (mmol/l)/random urine creatinine (mmol/l) to obtain:
24h urine sodium predicted value (mmol/d)=- 65.6155+2.7387 × ages (year) -0.0297 × age2(year2)+ 0.2685 × random urine sodium (mmol/l) -1.6453 × random urine sodium potassium+2.43282218 × random urine of ratio sodium (mmol/l)/with Machine urine creatinine (mmol/l)+1.1855 × weight (kg).
Above-mentioned conversion relation is:By urine a sodium SUNA (mmol/l), point urine creatinine SUCR (umol/l), if its be respectively M, NSUNA/SUCR (Mmol/mg)=M/N × 8.841, if it is XSUNA/SUCR (mmol/l ÷ mmol/l)=M/N × 1000, If it is Y
∴ X ÷ 8.841=Y ÷ 1000=M/N
∴ X=8.841 ÷ 1000*Y=8.841*10^ (- 3) * Y
275.175*X=275.175 × 8.841*10^ (- 3) * Y=2.43282218*Y in ∴ formula
The point urine sodium value refers to the point urine sodium value in the urine sample (SM U sample) that women random urine is left and taken;
The point urine potassium value refers to the point urine potassium value in the urine sample (SM U sample) that women random urine is left and taken;
Described urine creatinine value refers to the point urine creatinine value in the urine sample (SMU sample) that women random urine is left and taken.
Point urine sodium, the measure of potassium value use electrode method, and point urine creatinine value uses enzyme process.
Above-mentioned measuring device is further kit, and the kit includes:For the product of test point urine sodium value, it is used for Test point urinates the product of potassium value, is realized for the product of test point urine creatinine value, and by equation below:
24h urine sodium predicted value (mmol/d)=- 65.6155+2.7387 × ages (year) -0.0297 × age2(year2)+ 0.2685 × random urine sodium (mmol/l) -1.6453 × random urine sodium potassium+2.43282218 × random urine of ratio sodium (mmol/l)/with Machine urine creatinine (mmol/l)+1.1855 × weight (kg).
In the kit, the point urine sodium value refers in the urine sample (SM U sample) that women random urine is left and taken Point urine sodium value;
The point urine potassium value refers to the point urine potassium value in the urine sample (SM U sample) that women random urine is left and taken;
Described urine creatinine value refers to the point urine creatinine value in the urine sample (SMU sample) that women random urine is left and taken.
It is described to urinate sodium value for test point and put the product for urinating potassium value concretely Beckman DXC800 full-automatic biochemicals minute Analyzer.
The product for test point urine creatinine value concretely Beckman DXC800 automatic clinical chemistry analyzers.
The application method of the above-mentioned kit for women twenty-four-hour urine sodium value falls within protection scope of the present invention.
The application method of the kit of the women twenty-four-hour urine sodium value, comprises the following steps:
1) test point urine sodium value, point urine potassium value and point urine creatinine value;
2) point is urinated sodium value, point urine potassium value and point urine creatinine value to substitute into equation below, it is small that women 24 is calculated When urinate sodium predicted value:
24h urine sodium predicted value (mmol/d)=- 65.6155+2.7387 × ages (year) -0.0297 × age2(year2)+ 0.2685 × random urine sodium (mmol/l) -1.6453 × random urine sodium potassium+2.43282218 × random urine of ratio sodium (mmol/l)/with Machine urine creatinine (mmol/l)+1.1855 × weight (kg).
In above-mentioned application method, the point urine sodium value refers in the urine sample (SM U sample) that women random urine is left and taken Point urine sodium value;
The point urine potassium value refers to the point urine potassium value in the urine sample (SM U sample) that women random urine is left and taken;
Described urine creatinine value refers to the point urine creatinine value in the urine sample (SMU sample) that women random urine is left and taken.
In crowd according to the present invention the measuring device of female urine sodium value can high-precision and time saving (pendulous frequency etc.), Easily measure.
The quality of sodium in diet is calculated by twenty-four-hour urine sodium, further according to proportion of the sodium in sodium chloride and sodium chloride in salt In ratio (99%) calculate daily ingestion of salt amount (g) so that the daily ingestion of salt for hyperpietic even general population Amount provides objective observation index, this judges whether hyperpietic's Salt intake is exceeded for help and instructs their life Mode and drug therapy play an important role.
Brief description of the drawings
The Bland-Altman that Fig. 1 is SUN3 method entirety crowds schemes.
The Bland-Altman that Fig. 2 is Kawasaki method entirety crowds schemes.
Fig. 3 A1, A2, B1, B2 are respectively SUN3 methods male, SUN3 methods women, Kawasaki methods male, Kawasaki method female Property Bland-Altman figure.
Embodiment
Below by specific embodiment, the present invention will be described, but the present invention is not limited thereto.
Experimental method used in following embodiments is conventional method unless otherwise specified;Institute in following embodiments Reagent, biomaterial etc., are commercially available unless otherwise specified.
Embodiment 1
The foundation of the method for the present invention
Data come from 2011.8-2016.1 The People's Hospital of Peking University's hypertension ward be in hospital age in 15-90 The hyperpietic in year.If research object is with serious multisystem disease (such as rheumatism immunological disease and tumour) and the high blood of Secondary cases Pressure, merges serious liver and kidney disease, infection, tumour, malnutrition, severe cardiac renal insufficiency, cardiovascular and cerebrovascular occurs within nearly 6 months Event (heart infarction, cerebral apoplexy), hypertension emergency, diuretics is used using glucocorticoid, in nearly January or contains diuretics Monolithic compound preparation, or twenty-four-hour urine amount are less than 500ml, fail completely to gather urine person, will be excluded.
Age, gender, Smoking And Drinking situation, in the recent period collection patient medication information, drink are recorded when all selected personnel are admitted to hospital Food situation, measurement height (cm), weight (Kg), admission day seat upper arm blood pressure (mmHg).Blood pressure measuring method is according to 2010 Year Chinese hypertension prevention and control guide, the quiet rest of seat 30 minutes before measuring blood pressure, no smoking, drink coffee and tea, empty bladder; Subject takes seat, exposed upper arm, and upper arm is in same level with heart.Mercury sphygmomanometer is selected, interval 1-2min is repeated Measurement, takes the average value record of 3 readings.
Professional training personnel inform how research object collects twenty-four-hour urine liquid and the random urine gathered before this (≈ 3- 5ml), i.e.,:From first day early morning 7:00 empty bladder simultaneously discards, according to this when start timing, the urine discharged 24 when small is complete Portion stores, including the 2nd day morning 7:00 urine solved.Stay the urine time be less than 24 it is small when or patient's narration have the loss or 24 of urine Hour, total volume of urine < 500mL were excluded.And Record analysis object leaves and takes the start and end time of twenty-four-hour urine liquid, and leave and take The time of random urine.Research object uses normal diet during collection urine.
Urine sodium, the measure of potassium use electrode method, and creatinine uses enzyme process.
Research object is randomly divided into development group (n=1164) and validation group (n=388).After gender layering, in development group In, random urine sodium (mmol/l), random urine potassium (mmol/l), random urine creatinine (umol/l), age, age 2, body are sought respectively Weight, point urine sodium creatinine than, point urine sodium potassium than the relation with twenty-four-hour urine sodium.Whether enter regression equation and assessment is examined according to t, and With correction R2Estimate equation degree of fitting.
The regression equation that development group is obtained is verified applied to validation group.Judgement schematics applicability:Compare from average, Correlation, accuracy, Bland-Altman figures, under ROC curve area AUC describe twenty-four-hour urine sodium excretion predicted value (eUNa) and The relation of measured value (UNa).Average compares using paired t-test.Divide during correlation analysis normal distribution using Pearson is related Analysis, when Non-Gaussian Distribution, use Spearson correlation analyses.Accuracy evaluation falls into r-UNa ± 30%, ± 50% with e-UNa Case percentage represents.Compliance evaluation schemes to examine with Bland-Altman.Area AUC comparison prediction formula are examined under ROC curve Disconnected urine sodium it is whether exceeded (>Sensitivity and Specificity 100mmol/d).With the ROC curve point nearest apart from the reference axis upper left corner The optimal threshold (i.e. sensitiveness+specificity highest point) whether exceeded as diagnosis urine sodium.
All data using Empowerstats statistical softwares (www.empowerstats.com, X&Y solutions, Inc.,Boston,MA)、R(http://www.R-project.org) processing analysis.
(2) total crowd's Baseline Data such as table 1
Table 1
Note:Point urine sodium creatinine ratio=urine sodium (mmol/l)/urine creatinine (mg/l)=urine sodium (mmol/l)/urine flesh Acid anhydride (umol/l) * 8.841=points urine sodium (mmol/l)/urine creatinine (mmol/l) * 8.841*10-3
In development group, after gender layering, with random urine sodium, random urine potassium, random urine creatinine, age, age2, weight, Point urine sodium creatinine ratio, point urine sodium potassium ratio are independent variable, and twenty-four-hour urine sodium is dependent variable, screen all possible variable combination, build Vertical regression equation, overall merit R2Deng after, best of breed is found, coefficient is as follows:
2 development group regression equation coefficient of table
Applicability is assessment using formula predictions twenty-four-hour urine sodium and the consistent degree of measured value.Will be from accurate in this research Property, uniformity and sensitivity and the several aspects of specificity carry out SUN3 formula applicability assessment and are carried out with Kawasaki formula Compare
Table 3SUN3 formula
Kawasaki formula:E-24hUNa=16.3 × [PRCr × (SUNa/SUCr)]0.5
PRCr (man)=- 12.63 × age+7.39 × height+15.12 × weight -79.9
PRCr (female)=- 4.72 × age+5.09 × height+8.58 × weight -74.95
Point urine sodium (SUNa), point urine creatinine (SUCr)
The verification of embodiment 2, the method for the present invention
Research object information is substituted into Kawasaki formula, and the predicted value one calculated with SUN3 formula newly developed Rise, compared with urinating sodium measured value with 24h.
Verification process is mainly embodied by following aspect:
1) comparison of average, correlation
2) comparison of accuracy:Accuracy is defined as predicted value and falls into measured value ± 15%, ± 30%, ± 50% percentage Than being denoted as P15, P30, P50 respectively
The comparison of uniformity:With Bland-Altman graph evaluations.
Judge the exceeded comparison of urine sodium:Predict whether natruresis is exceeded (i.e. for three kinds of methods of evaluation>100mmol/d) Sensitivity and specificity, ROC curve, exceeded (the urine sodium > 100mmol/ of definition urine sodium are by point of contact of actual measurement urine sodium 100mmol/d D) it is the positive, draws area under ROC curve (AUC)
The comparison of 4 each method of table and measured value
*:Compared with measured value, P > 0.05
**:Compared with SUN3 methods, Chi-square Test P<0.05
5 each method Bland-Altman figures of table compare
As can be seen that in three kinds of methods, the method for Kawasaki has substantially over-evaluated measured value.This trend is in gender point Also exist substantially after layer.It is therefore more applicable from verification result, SUN3.
The point urine formula assessment urine sodium of SUN3 methods differs -0.55mmol/ in overall Hypertensive Population with measured value average D, equivalent to salt -0.033g.
(1) by the point urine formula of SUN3 methods is compared with Kawasaki methods and the measured value with urinating sodium is verified, it can be seen that:SUN3 Average, correlation, accuracy, the uniformity of method are significantly better than Kawasaki methods.
(2) SUN3 methods judge to urinate the whether exceeded sensitivity of sodium and specificity (area AUC=0.810 under ROC curve)
Significantly better than Kawasaki methods.
Determine point of contact
In view of the practical use of the formula, it is intended that foundation judges to urinate whether exceeded (the > 100mmol/d of sodium【China Guide recommends salt intake not exceed 6g/d, equivalent to urine sodium 100mmol/d】) point of contact.Formula is substituting to all groups (development group+validation group), with twenty-four-hour urine sodium measured value > 100mmol/d be denoted as urine sodium it is exceeded (positive), establish ROC curve, Find the cut off value of susceptibility+specificity maximum.After gender layering, optimal point of contact result is as follows:
The exceeded optimal threshold of table 6SUN3 methods diagnosis urine sodium
Therefore work as male urine sodium predicted value > 149mmol/d, during female urine sodium predicted value > 112mmol/d, it is believed that urine sodium It is exceeded.

Claims (7)

1. a kind of measuring device of female urine sodium value, including urine component amount detection unit, it is drained in a period of regulation Among point urine, component amount included in test point urine, the component amount includes point urine sodium value, point urine potassium value and point urine creatinine Value;And twenty-four-hour urine sodium predictor calculation unit, according to component amount included in a urine, when women 24 is small in calculating crowd Urinate sodium predicted value.
2. measuring device according to claim 1, it is characterised in that:The twenty-four-hour urine sodium value computing unit is according to equation below Calculated:
24h urine sodium predicted value (mmol/d)=- 65.6155+2.7387 × ages (year) -0.0297 × age2(year2)+0.2685 × random urine sodium (mmol/l) -1.6453 × random urine sodium potassium+2.43282218 × random urine of ratio sodium (mmol/l)/random urine flesh Acid anhydride (mmol/l)+1.1855 × weight (kg).
3. measuring device according to claim 1, it is characterised in that:The point urine sodium value refers to the urine sample that women random urine is left and taken Point urine sodium value in this (SM U sample);
The point urine potassium value refers to the point urine potassium value in the urine sample (SM U sample) that women random urine is left and taken;
Described urine creatinine value refers to the point urine creatinine value in the urine sample (SMU sample) that women random urine is left and taken.
4. according to claim 1-3 any one of them measuring devices, it is characterised in that:The measuring device is kit, institute Stating kit includes:For the product of test point urine sodium value, for the product of test point urine potassium value, for test point urine creatinine value Product, and realized by equation below:
24h urine sodium predicted value (mmol/d)=- 65.6155+2.7387 × ages (year) -0.0297 × age2(year2)+0.2685 × random urine sodium (mmol/l) -1.6453 × random urine sodium potassium+2.43282218 × random urine of ratio sodium (mmol/l)/random urine flesh Acid anhydride (mmol/l)+1.1855 × weight (kg).
5. according to any measuring devices of claim 1-3, it is characterised in that:The point urinates sodium, the measure of potassium value is adopted With electrode method, point urine creatinine value uses enzyme process.
6. a kind of measuring method of female urine sodium value, comprises the following steps:Component amount calculation procedure in urine, in urinating in this step Component amount, the component amount included in test point urine among the point urine that component amount computing unit is drained in a period of the regulation Including a urine sodium value, point urine potassium value and point urine creatinine value;And twenty-four-hour urine sodium value calculation procedure, it is small by 24 in this step When urinate sodium value computing unit, according to urine included in component amount, calculate women twenty-four-hour urine sodium value.
7. a kind of application method of the measuring device of female urine sodium value, comprises the following steps:
1) test point urine sodium value, point urine potassium value and point urine creatinine value;
2) point is urinated sodium value, point urine potassium value and point urine creatinine value to substitute into equation below, women twenty-four-hour urine is calculated Sodium value:
24h urine sodium predicted value (mmol/d)=- 65.6155+2.7387 × ages (year) -0.0297 × age2(year2)+0.2685 × random urine sodium (mmol/l) -1.6453 × random urine sodium potassium+2.43282218 × random urine of ratio sodium (mmol/l)/random urine flesh Acid anhydride (mmol/l)+1.1855 × weight (kg).
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Cited By (1)

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Publication number Priority date Publication date Assignee Title
CN111508584A (en) * 2020-04-24 2020-08-07 孙宁玲 Method for evaluating daily salt intake of hypertension patient by random urine instillation

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CN107271652A (en) * 2016-04-06 2017-10-20 杨甫进 A kind of measurement apparatus and method of female urine sodium value

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111508584A (en) * 2020-04-24 2020-08-07 孙宁玲 Method for evaluating daily salt intake of hypertension patient by random urine instillation
CN111508584B (en) * 2020-04-24 2023-08-01 孙宁玲 Method for evaluating daily salt content of hypertensive patient by using random urine infusion

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