尿液Lipocalin型前列腺素D合酶含量测定在妊娠期高血压疾病中的评估价值

The Clinical Significance of Urine Prostaglandin-H2 D-isomerase in Hypertensive Disorders of Pregnancy

目的:探讨Lipocalin型前列腺素D合酶(L-PGDS)在评估妊娠期高血压疾病肾脏损伤中的临床价值。方法:选择正常健康足月妊娠、妊娠期高血压、轻度子痫前期和重度子痫前期孕妇各20例,分别对其尿液中的L-PGDS浓度进行检测,并与平均动脉压(MAP)和24小时(24 h)尿蛋白进行相关性分析。结果:妊娠期高血压患者尿液中L-PGDS浓度和正常妊娠孕妇比较,差异无统计学意义(P>0.05);而轻度子痫前期和重度子痫前期患者尿液中L-PGDS浓度低于正常妊娠女性和妊娠期高血压患者,差异均有统计学意义(P<0.01),且重度子痫前期尿液中LPGDS浓度显著低于轻度子痫前期组(P<0.01)。Pearson相关分析显示尿液中L-PGDS浓度与MAP、24 h尿蛋白均呈显著负相关关系(P<0.05)。结论:尿液L-PGDS水平可以用来评估妊娠期高血压疾病肾脏损伤的程度,能较好地区别妊娠期高血压和子痫前期,在一定程度上反映疾病的严重程度。

Objective：To evaluate the significance of the urine prostaglandin-H2 D-isomerase（L-PGDS）in the evaluation of hypertensive disorders of pregnancy. Methods：Urine L-PGDS concentrations were measured in 20 normal pregnancies and 20 cases of gestational hypertension, mild preeclampsia and severe preeclampsia respectively. Then we did correlation analysis between urine L-PGDS and mean arterial pressure and 24-h urine protein. Results：There was no significance in concentration of urine L-PGDS between gestational hypertension and normal pregnancies（ P〉0. 05）. However,the concentrations of urine L-PGDS in mild preeclampsia and severe preeclampsia were significantly lower than that of normal pregnancies（ P 〈0. 01 ）, and there was higher concentration in mild preeclampsia when compared with severe preeclampsia （ P 〈 0. 01 ）. Correlation analyses demonstrated that significant negative correlations could be detected between urine L-PGDS and mean arterial pressure,24-h urine protein （P 〈 0. 05）. Conclusions： Urine L-PGDS level can work as a good marker to reflect the kidney damage state of hypertensive disorders in pregnancy, and to distinguish preeclampsia from gestational hypertension, and to reflect the severity of the disease.