尿微量白蛋白和血清胱抑素C检测在妊娠高血压妇女早期肾损伤诊断中的应用

The role of urinary micro-albumin and serum cystatin C in early diagnosis in pregnancy-induced hypertension patients with renal injury

目的探讨尿微量白蛋白(mAlb)和血清胱抑素C(CysC)在妊娠高血压孕妇早期肾损伤早期诊断中的应用。方法用酶法测定妊娠高血压不同实验组和正常对照组的血清尿素氮、肌酐浓度,用增强比浊法测定血清CysC浓度,用免疫散射法测定尿液mAlb,对结果进行统计处理。结果妊娠期高血压组、轻度子痫前期组和重度子痫前期组尿mAlb与对照组相比,均升高(均P<0.05);而血清CysC、尿素氮、肌酐重度子痫前期组与对照组相比均升高(均P<0.05),其他两组与对照组相比差异无统计学意义(均P>0.05),随着妊娠妇女病情的加重,尿mAlb的升高比其他三项指标更快速和灵敏。结论检测尿mAlb有助于监测妊娠高血压病孕妇肾损害程度及妊娠高血压病的诊断分级;而血清CysC则是重度子痫前期孕妇的敏感指标,其异常升高应引起临床高度重视。

Objective To investigate the role of urinary micro-albumin （mAlb） and serum cystatin C （CysC） in early diagnosis of pregnancy induced hypertension in patients with renal injury. Methods The urea nitrogen and creatinine concentration in serum were determined by enzymes-based method, while CysC concentration in serum was measured by an enhanced turbidimetric method. The mAlb in urine was performed by immune scattering method as well. These data were analyzed by correlation analysis. Results The results of mAlb in the pregnancy-induced hypertension, mild pre-eclampsia and severe pre-eclampsia groups were sig- nificantly higher （P 〈 0.05） than those in the health control group. The serum CysC, urea nitrogen and creati- nine in the severe group were significantly higher （P 〈 0.05） than those in the control group. However, there was no significant correlations （P 〉 0.05） between the other two groups and the control group. Moreover, with the aggravation of pregnancy-induced hypertension, the positive rate of urinary albumin increased rapidly and sensitively than other three indicators. Conclusion Urine mAlb is the most sensitive indicator in early diag- nosis of kidney damage in patients with pregnancy-induced hypertension, while serum CysC is an endogenous indicator which is more specific for early diagnosis of severe pre-eclampsia pregnants.