尿转铁蛋白测定对早期妊娠高血压综合征诊断的临床价值

The clinical value of urine transferrin testing in early pregnancy-induced hypertension syndrome

目的 探讨尿转铁蛋白测定对于妊娠高血压综合征（PIH）并发肾损害早期诊断的临床意义.方法 选择2012年1月至2013年10月收治的PIH患者68例（PIH组）,其中轻度21例,中度24例,重度23例,选择同期进行体检健康者68例（对照组）,测定两组尿转铁蛋白、尿素和肌酐水平,并进行综合分析.结果 与对照组比较,PIH组患者的尿转铁蛋白、尿素和肌酐浓度均有显著性升高[（3.01±1.82） mg/L比（1.29±0.88） mg/L、（13.12 ±5.5） mmol/L比（6.23±3.68） mmol/L、（135.5±62.3）μmol/L比（85.1±38.2）μmol/L],差异有统计学意义（P＜0.05）.轻度PIH患者尿转铁蛋白、尿素、肌酐灵敏度分别为76.19％,61.90％,57.14％,中度PIH患者分别为75.00％,79.17％,75.00％,重度PIH患者分别为78.26％,86.96％,73.91％,尿转铁蛋白、尿素、肌酐特异度分别为80.65％,56.45％,58.06％.不同程度的PIH患者的尿转铁蛋白灵敏度≥75.00％,轻度PIH患者尿转铁蛋白灵敏度与同期患者的尿素和肌酐灵敏度比较差异有统计学意义（P＜0.05）,但中、重度比较差异无统计学意义（P＞0.05）;尿转铁蛋白的特异度与尿素和肌酐比较差异有统计学意义（P＜0.05）.结论 尿转铁蛋白是临床辅助诊断PIH并发肾损害早期较敏感且特异的检测指标,其水平检测能反映PIH患者肾小管和肾小球早期功能性损伤程度,对PIH的临床诊治具有重要的临床意义.

Objective To explore the clinical significance of urine transferrin testing in the diagnosis of early pregnancy-induced hypertension syndrome （PIH）. Methods Sixty-eight PIH patients （PIH group） who received treatment from January 2012 to October 2013 were enrolled in this study. Mild P1H was 21 patients, midrange PIH was 24 patients and severe PIH was 23 patients. Meanwhile, 68 cases of healthy person were selected as control group. The level of urine transferrin, urea and creatinine were compared between two groups. Results The level of urine transferrin, urea and creatinine in PIH group were significantly higher than those in control group[ （3.01 ± 1.82） mg/L vs. （1.29 ± 0.88 ） mg/L, （13.12 ±5.51） mmol/Lvs. （6.23±3.68） n,mol/L,（135.5±62.3） umol/Lvs. （85.1 ±38.2） umol/L]（P〈0.05）. The sensitivity of urine transferrin, urea and creatinine in mild PIH was 76.19% ,61.90% ,57.14%. In midrange PIH was 75.00%, 79.17%, 75.00%. In severe PIH was 78.26%, 86.96%, 73.91%. The specificity of urine transferrin, urea and ereatinine was 80.65%, 56.45%, 58.06%. The sensitivity of different degree of PIH was exceeded 75.00%. The sensitivity of urine transferrin in mild PIH was significantly higher than urea and creatinine （P 〈 0.05 ）. But the sensitivity of urine transferrin in midrange PIH and severe PIH had no significant difference （P 〉 0.05 ）. The specificity of urine transferrin was significantly higher than urea and creatinine （P 〈 0.05 ）. Conclusions Urine transferrin is a good index in diagnosis of early PIH, which can reflect the early injury degree of the renal tubular and glomerular. It has active and important significance for the clinical diagnosis and treatment of PIH.