血清胱抑素C在妊娠期高血压疾病变化中的临床意义和应用

Clinical application of serum cystatin C Level change in hypertensive disorder complicating pregnancy

目的探讨血清胱抑素C（Cys-C）水平与妊娠期高血压疾病变化的关系,评估胱抑素C对妊娠期高血压疾病诊断价值。方法随机抽取2012年10月至2013年10月宿州市立医院住院分娩孕产妇为研究对象。收集妊娠期高血压疾病65例,同时选择健康孕妇30例作为对照组,检测孕妇血清Cys-C、β2微球蛋白（β2-MG）、尿素氮（BUN）进行比较。结果妊娠期高血压疾病组各项指标水平均高于对照组,差异有统计学意义（P〈0.05）。妊娠期高血压疾病组血清Cys-C与β2-MG、BUN呈正相关,差异有统计学意义（r=0.424,P〈0.05）。此外,运用SPSS 13.0软件分析获得Cys-C、β-MG和BUN的受试者工作特征（ROC）曲线下面积分别为0.947、0.727、0.641,差异有统计学意义（P〈0.05）。Cys-C诊断妊娠高血压疾病的最佳临界点为1.25 mg/L,并具有较高的灵敏度和特异度。其可疑值范围为1.08～1.25 mg/L。结论 Cys-C在评价妊娠期高血压疾病早期肾损害临界值是1.25 mg/L,Cys-C比β2-MG、BUN更能早期发现妊娠高血压肾功能的改变,对评价病情的发展也有重要的作用。

Objective To explore the relationship between serum cystatin C level and hypertensive disorder complicating pregnancy（ HDCP）,and to evaluate the diagnostic value of cystatin C in HDCP. Methods 65 pregnant women with HDCP hospitalized in the Suzhou Municipal Hospital from October 2012 to October 2013 were randomly selected as research objects. Meanwhile,30 healthy pregnant women were selected as the controls. The 1evels of cystatin C（ Cys-C）,β2-microglobulin（ β2-MG） and BUN were detected and compared between the two groups.Results The levels of Cys-C,β2-MG and BUN in HDCP group were all higher than those of control group,and the difference was statistically significant（ P 0. 05）. The level of serum Cys-C in HDCP group was positively correlated with β2-MG and BUN levels. Meanwhile,it was the mostly associated with β2-MG level（ r = 0. 424,P 0. 05）. In addition,The area under receiver operating characteristic（ ROC） curves of Cys-C,β2-MG and BUN were 0. 947,0. 727 and 0. 641 respectively by the SPSS 13. 0 software. And the difference was statistically significant（ P 0.01）. The cut off value of the serum Cys-C was 1.25 mg/L for diagnosis of HDCP with higher sensitivity and specificity. Suspicious value of range was 1. 08 mg /L to 1. 25 mg /L. Conclusion The cut off value of the serum Cys-C is 1. 25 mg /L in the evaluation of early renal damage of HDCP. Cys-C changed in the early detection of pregnancy hypertension renal more than β2-MG and BUN. It plays an important role to find the change of renal function and evaluate the progression of the disease.