子前期患者血清心肌肌钙蛋白Ⅰ和半胱氨酸蛋白酶抑制剂C的变化及其临床意义

Changes of serum cardiotropin I and cystatin C in preeclampsia and clinical significance thereof

目的探讨子前期患者血清心肌肌钙蛋白Ⅰ和半胱氨酸蛋白酶抑制剂C测定的临床价值。方法采用酶联免疫吸附法测定40例子前期孕妇(子前期组),40例正常孕妇(对照组)妊娠晚期血清心肌肌钙蛋白Ⅰ和半胱氨酸蛋白酶抑制剂C水平,同时测定两组孕妇的血清肌酸激酶、肌酐与尿酸水平。结果(1)子前期组血清心肌肌钙蛋白Ⅰ水平为(0.59±0.42)μg/L,对照组为(0.09±0.22)μg/L,P<0.001;(2)子前期组血清半胱氨酸蛋白酶抑制剂C水平为(1.64±0.47)mg/L,对照组为(1.08±0.19)mg/L,P<0.001;(3)重度子前期患者血清心肌肌钙蛋白Ⅰ水平为(0.66±0.40)μg/L,轻度患者为(0.17±0.26)μg/L,P<0.001;重度患者血清半胱氨酸蛋白酶抑制剂C水平为(1.72±0.46)mg/L,轻度患者为(1.21±0.37)mg/L,P<0.05。结论子前期患者血清心肌肌钙蛋白Ⅰ和半胱氨酸蛋白酶抑制剂C水平升高,与病情密切相关,提示血清心肌肌钙蛋白Ⅰ和半胱氨酸蛋白酶抑制剂C可能是早期诊断心肌、肾功能损害的理想指标。

Objective To investigate the changes and of serum cardiotropin Ⅰ （CTN Ⅰ ） and cystatin C in preeclampsia clinical significance thereof. Methods Peripheral blood samples were collected from 40 women with preeclampsia, aged 29 （ 18-39 ）, with the medium gestational age of 35 weeks, and 40 age- and gestational age-matched controls. Serum cTN Ⅰ and cystatin C were determined with ELISA and serum levels of creatinin kinase, creatinine, and uric acid were assayed by automatic biochemical analyzer. Comparison was made between the 2 groups. Results The serum cTn Ⅰ of the preclampsia group was 0. 59 μg/L ± 0.42 μg/L, significantly higher than that of the control group （0.09 μg/L ± 0. 22 μg/L P 〈 0. 001 ）, and the serum cystatin C of the preclampsia group was 1.64 mg/L ± 0.47 mg/L, significantly higher than that of the control group （ 1.08 mg/L ± 0. 19 mg/L, P 〈 0. 001 ）. And the serum cardiotropin I and cystatin C concentrations of the patients with severe preeclampsia were 0.66 μg/L ± 0.40 μg/L and 1.72 mg/L ± 0.46 mg/L respectively, both significantly higher than those of the patients with mild preclampsia （0.17 μg/L ± 0.26 μg/L and 1.21 mg/L ± 0. 37 mg/L respectively, P 〈 0. 001 and 0. 05 respectively）. Conclusion Serum cTn I and cystatin C levels are elevated in preeclampsia and the elevation is associated with the severity of preeclampsia, suggesting that serum concentrations of cTn Ⅰ and cystatin C are useful markers in the early diagnosis of cardiac and renal injury in patients of preeclampsia.