血清胱抑素C联合尿微量白蛋白检测在妊娠期高血压疾病早期肾损害诊断中的价值

Diagnosis of early renal injury in pregnancy patients withhy pertensive disorder complicating pregnancy bydetectionof serum cystain C and urine microalbumin

目的探讨血清胱抑素C(Cys C)联合尿微量白蛋白(mALB)对妊娠期高血压疾病(HDCP)早期肾损害的诊断价值。方法选取本院产科收治的HDCP孕妇150例(患者组)及正常妊娠孕妇147例(对照组),患者组孕妇按照病情严重程度进一步分为妊娠期高血压组60例,轻度子痫前期组51例,重度子痫前期组39例,检测患者组及对照组血清Cys C、BUN、肌酐(SCr)及尿mALB。结果患者组各指标水平明显高于对照组(P<0.05);妊娠期高血压组与轻度子痫前期组各检测指标比较,BUN与SCr指标无显著差异(P>0.05),CysC与尿mALB差异有统计学意义(P<0.05);轻度子痫前期组与重度子痫前期组各检测指标比较,差异均有统计学意义(P<0.05)。相关分析发现,患者组血清CysC与尿mALB水平呈正相关(r=0.671,P<0.05)。结论 HDCP孕妇早期即存在血清Cys C及尿mALB水平增高,且随病情加重呈上升趋势,两者联合检测有利于尽早发现HDCP孕妇早期的肾损害。

Objective To explore early diagnosis of early renal injury in pregnancy patients with hypertensive disorder complicating pregnancy（HDCP） by detection of serum cystain C（Cys C）and urine microalbumin（mALB）. Methods A total of 150 pregnant women with HDCP were in the study group and 147 normal pregnant women were in control group. The pregnant women in study group were further divided into gestational hypertension group（60 pregnant women）,mild preeclampsia group（51 pregnant women） and severe preeclampsia group（39 pregnant women） according to severity of the disease; The levels of Cys C,BUN,Scr and microalbumin（mALB） were detected. Results The levels of Cys C,BUN,Scr and mALB in study group were significantly higher than those in control group（P〈0. 05）. The difference in levels of BUN and Scr was not statistically significant（P〈0. 05）. The levels of CysC and mALB were statistically significant between the gestational hypertension group and the mild preeclampsia group. The difference in levels of BUN,Scr,Cys C and mALB was statistically significant between the mild preeclampsia group and the severe preeclampsia group（P〉0. 05）. The difference was significant in close positive correction between the level of Cys C and mALB（r = 0. 671,P〈0. 05）. Conclusion The increasing levels of CysC and mALB cause the worsening of the diseases. It is helpful to diagnose early renal injury of HDCP by combinative detection of serum Cys C and urine mALB.