化学发光法检测尿液非对称二甲基精氨酸的临床价值评估

Clinical value assessment of chemiluminescence for urine asymmetric dimethylarginine

目的探讨化学发光法检测尿液非对称二甲基精氨酸(ADMA)在妊娠期高血压(PIH)的临床应用价值。方法采用病例对照研究,选取2014年5月至2015年4月就诊于湖州市妇幼保健院的72例PIH患者和60名体检正常孕妇的24 h尿液样本,用化学发光法(CLIA)和高效液相色谱法(HPLC)检测尿液中ADMA含量,比较两种方法检测尿液ADMA的各项指标,并进行秩和检验、受试者工作曲线(ROC曲线)和Pearson相关分析统计学分析。结果与正常对照组相比,HPLC和CLIA检测PIH组尿液ADMA浓度均显著升高,其中CLIA检测PIH组尿液ADMA浓度为68.18(57.25,81.55)μmol/L高于正常对照组30.11(22.69,42.97)μmol/L(Z=-8.139,P<0.001),HPLC检测PIH组尿液ADMA浓度为71.11(57.65,82.89)μmol/L高于正常对照组28.11(21.06,42.99)μmol/L(Z=-8.356,P<0.001),差异均有统计学意义。两种方法学检测尿液ADMA浓度均与PIH血压呈高度正相关,相关系数r值分别为0.746、0.763,P值分别为0.007、0.008。结论化学发光法能较好的检测PIH患者尿液中ADMA浓度,并具有较好的临床诊断能力,尿液中的ADMA浓度与PIH血压水平具有相关性。

Objective To explore the clinical application value of chemiluminescence detection of urine asymmetric dimethylarginine (ADMA) in pregnancy-induced hypertension (PIH). Methods Collected the 24 h urine from 60 normal pregnancy women and 72 PIH pregnancy women who were admitted to Huzhou Maternal and Child Health Hospital from May 2014 to April 2015 by the case-control study, Determination of urine ADMA content by chemiluminescence (CLIA) and high performance liquid chromatography (HPLC), the results between two assays were analyzed by the Rank sum test, receiver operating characteristic (ROC) curve and pearson correlation analysis. Results Compared with the normal control group, the urine ADMA concentration in the PIH group was significantly increased by HPLC and CLIA, and the concentration of ADMA by CLIA in the PIH group was 68.18(57.25, 81.55)μmol/L higher than that of the normal control group 30.11(22.69, 42.97)μmol/L(Z=-8.139, P<0.001), and the concentration of ADMA by HPLC in the PIH group by HPLC was 71.11(57.65, 82.89)μmol/L higher than that of the normal control group 28.11(21.06, 42.99)μmol/L(Z=-8.356, P<0.001). The difference was statistically significant.The two methods of urine ADMA concentration were highly positively correlated with PIH blood pressure. The correlation coefficient r values were 0.746 and 0.763, respectively, the P values were 0.007 and 0.008 respectively. Conclusions CLIA can better detect the ADMA concentration in urine of pregnant women with PIH, and has a good clinical diagnosis ability. The ADMA concentration in urine is related to the blood pressure level of PIH.