尿RBP、KIM-1与血Cys C联合检测预测妊娠期高血压患者肾损伤临床研究

Clinical Study on Joint Detection of Urine RBP,KIM-1 and Serum Cys C in Prediction of Renal Injury of Patients with Gestational Hypertension

目的研究尿视黄醇结合蛋白(retinol-binding protein,RBP)、肾损伤分子1(kidney injury molecule 1,KIM-1)、血清胱抑素C(cystatin C,Cys C)联合检测在预测妊娠期高血压患者肾损伤方面的临床应用价值。方法选取我院2015年1月至2016年10月收治的40例妊娠期高血压孕妇作为研究组,另选取我院同期收治的40例无妊娠期高血压正常妊娠分娩孕妇作为对照组。两组孕妇均接受尿RBP、KIM-1及血清Cys C联合检测。比较两组孕妇尿RBP、KIM-1及血清Cys C水平,并分析药时曲线下面积(AUC)。结果研究组患者尿RBP、KIM-1及血清Cys C水平均明显高于对照组,差异有统计学意义(P<0.05);ROC曲线显示,尿RBP、KIM-1及血清Cys C在预测妊娠期高血压患者肾损伤方面均具有参考价值,但联合检测灵敏度、特异性及AUC面积均高于单独检测,差异有统计学意义(P<0.05)。结论妊娠期高血压孕妇的尿RBP、KIM-1及血清Cys C水平高于正常孕妇,根据尿RBP、KIM-1及血清Cys C水平能判定孕妇有无妊娠期高血压及肾损伤。但采用尿RBP、KIM-1与血清Cys C联合检测具有更高的灵敏度与特异性,能对妊娠期高血压患者肾损伤进行较好的早期预测,为临床诊治提供参考依据。

Objective To study the clinical application value of joint detection of urine retinol- binding protein （RBP）, kidney injury molecule 1 （KIM-1） and serum cystatin C （CysC） in prediction of renal injury of patients with gestational hypertension. Methods 40 pregnant women with gestational hypertension admitted into our hospital from January 2015 to October 2016 were selected as research group, and 40 healthy pregnant women without gestational hypertension were selected as control group at the same time. Both groups were performed with the joint detection of urine RBP, KIM-1 and serum Cys C. The urine RBP, KIM-1 and serum Cys C concentration of both groups were compared, and the area under the curve （AUC） was analyzed. Results The urine RBP, KIM-1 and serum Cys C concentration of research group were significantly higher than control group （P 〈 0.05 ） ; ROC curve showed that urine RBP, KIM-1 and serum Cys C had reference value in prediction of renal injury of patients with gestational hypertension, but the sensitivity, specificity and AUC area of joint detection were higher than single detection （ P 〈 0.05 ）. Conclusion The urine RBP, KIM- 1 and serum Cys C levels of pregnant women with gestational hypertension are higher than those of normal pregnant women. It can determine pregnant women whether having gestational hypertension combined with renal injury according to urine RBP, KIM-1 and serum CysC levels. But joint detection of urine RBP, KIM-1 and serum Cys C has higher sensitivity and specificity, which can provide reference for early prediction and clinical diagnosis of renal injury of patients with gestational hypertension.