β2-MG、α1-MG、MCP-1在孕有单侧肾积水胎儿孕妇尿液中的检测及其意义

Correlation between the levels of β2-MG, α1-MG, MCP-1 in urine of pregnant women with unilateral hydronephrosis fetal

目的探讨孕妇尿液中β2-微球蛋白（β2-MG）、α1-微球蛋白（α1-MG）、单核细胞趋化蛋白-1（MCP-1）的检测水平与胎儿单侧肾积水的相关性。 方法收集经彩色多普勒超声检查确诊胎儿为单侧（左侧或右侧）肾积水（未合并其他系统疾病）孕妇130例的病历资料，并收集其24 h尿液，长期追踪回访至产后3个月，定期收集24 h尿液标本作为实验组。另收集经彩色多普勒超声检查结果为正常胎儿（未发现合并疾病）的健康孕妇（未合并系统或器官疾病）80例，并收集其24 h尿液，长期追踪回访，定期收集24 h尿液标本为孕期对照组。于体检中心收集育龄期未孕成年女性80例的24 h尿液标本作为未孕对照组。根据妊娠阶段（孕早期、孕中期、孕晚期）、年龄因素进行分组配对，釆用酶联免疫吸附法（ELISA）测定三组尿中β2-MG、α1-MG、MCP-1含量并进行比较。 结果与孕期对照组和未孕对照组比较，实验组孕妇尿液中α1-MG水平明显升高，差异有统计学意义（P〈0.05），而β2-MG、MCP-1水平差异未见统计学意义（P〉0.05）；spearman秩相关提示随胎儿肾积水程度加重，孕妇尿液中α1-MG水平正相关性（rα1-MG＝0.440，P〈0.05），并于产后3个月下降。结论孕妇尿液中α1-MG检测水平与单侧肾积水胎儿疾病严重程度密切相关，随着肾积水程度加重呈正相关性，提示孕妇尿液中α1-MG水平可作为反映单侧肾积水胎儿肾功能受损的有效评估指标，但尚不能认为β2-MG、MCP-1具有类似作用。

ObjectiveTo investigate the correlation between the levels of β2-MG, α1-MG, MCP-1 in urine of pregnant women with unilateral hydronephrosis fetal. MethodsCollected 130 cases of medical records and the 24-hour urine of gravidas whose fetus with unilateral （left or right） hydronephrosis （not merged other system diseases） diagnosed by color doppler ultrasound at pediatric surgery clinics, making them as experimental group by long-term follow-up visit regularly collecting 24-hour urine specimen in further postpartum three months. Collected 80 cases of medical records and the 24-hour urine of healthy gravidas （not merge system or organ disease） whose fetus were normal（merger disease） diagnosed by color doppler ultrasound at pediatric surgery clinics, making them as pregnancy control group by long-term follow-up visit regularly collecting 24-hour urine specimen. Collected 80 cases of medical records and the 24-hour urine of adult women that childbearing age-to unfertilized at medical examination center, making them as nonpregnant control group by long-term follow-up visit regularly collecting 24-hour urine specimen. Matching groups according to the pregnancy stages （early, middle and late pregnancy） and age, using calculation method of enzyme linked immunosorbent （ELISA） to determine β2-MG, α1-MG and MCP-1 content in urine of three groups and compared the contents.ResultsCompared with pregnancy control group and nonpregnant control group, the level of α1-MG in urine of pregnant women in experimental group was significantly higher than that in control group, the difference was statistically significant（P〈0.05）. While, there were no significant differences in the levels of β2-MG, MCP-1 in each group（P〉0.05）. Spearman rank correlation showed that the levels of α1-MG in urine of pregnant women were positively correlated with the degree of fetal hydronephrosis（rα1-MG=0.440, P〈0.05）, and significantly decreased at postnatal stage. ConclusionsThe level of α1-MG in urine of pregnant women is closely related to the severity of hydronephrosis in fetuses, and there is positive correlation with the degree of hydronephrosis increased. It is suggested that the level of α1-MG in the urine of pregnant women can be used as an effective index to reflect the damage of renal function.