血清Hcy、Cys-C、NAG及mALB对妊娠期糖尿病患者早期肾损伤的检验诊断价值

Diagnostic value of serum Hcy,Cys-C,NAG and mALB in the diagnosis of early renal injury in gestational diabetes patients

目的探究血清Hcy、Cys-C、NAG及mALB对妊娠期糖尿病患者早期肾损伤的检验诊断价值。方法选取我院2016年1月至2018年1月收治的妊娠期糖尿病患者86例作为观察组,根据尿蛋白水平进一步细分为妊娠糖尿病组(尿蛋白<0.3 g/24 h)27例、子痫前期轻度组(尿蛋白<5 g/24 h)29例、子痫前期重度组(尿蛋白≥5 g/24 h)30例;根据肌酐清除率(Ccr)进一步细分为肾功能正常组(Ccr> 80 m L/min)45例,肾功能异常组(Ccr≤80 mL/min)41例。另选取我院同期的正常妊娠者86例作为对照组。分别检测各组血清Hcy、Cys-C及NAG、mALB、尿Cr、mALB/尿Cr数值,探究其与肾损伤间的联系。结果观察组血清Hcy、Cys-C及NAG、mALB、尿Cr、mALB/尿Cr均高于对照组,差异有统计学意义(P <0.05)。子痫前期重度组血清Hcy、Cys-C及NAG、m ALB、尿Cr、mALB/尿Cr均高于子痫前期轻度组,差异有统计学意义(P <0.05)。子痫前期轻度组血清Hcy、Cys-C及NAG、mALB、尿Cr、mALB/尿Cr均高于妊娠糖尿病组,差异有统计学意义(P <0.05)。肾功能异常组血清Hcy、Cys-C及NAG、mALB、尿Cr、mALB/尿Cr均高于肾功能正常组,差异有统计学意义(P <0.05)。观察组血清Hcy、Cys-C及NAG、mALB、尿Cr、mALB/尿Cr阳性率均高于对照组,差异有统计学意义(P <0.05)。联合检测灵敏度及特异度均显著高于单项检测,差异有统计学意义(P <0.05)。结论联合检测血清Hcy、Cys-C及NAG、mALB、尿Cr、mALB/尿Cr有利于诊断早期肾损伤,值得临床推广。

Objective To explore the diagnostic value of serum Hey, CysC,NAG and mALB for early renal injury in patients with gestational diabetes mellitus. Methods 86 cases of gestational diabetes mellitus admitted to our hospital from January 2016 to January 2018 were selected as observation group. They were divided into gestational diabetes group(urinary protein < 0.3 g/24 h) in 27 cases according to urinary protein level,preeclampsia Mild group(urinary protein < 5 g/24 h) in 29 cases, pre-eclampsia severe group(urine protein≥5 g/24 h) in 30 cases, and then further subdivided into normal renal function group according to creatinine clearance rate(Ccr)(Ccr > 80 mL/min) 45 cases, 41 cases of renal dysfunction group(Ccr≤80 mL/min). Another 86 normal pregnant women in the same period in our hospital were selected as control group. Serum Hcy, Cys-C and NAG,mALB, urine Cr and mALB/urine Cr values were detected respectively, and the relationship between them and renal injury was explored. Results Serum Hey, Cys-C and NAG, mALB, urinary Cr, mALB/urinary Cr were higher in the observation group than in the control group, and the difference was statistically significant(P < 0.05). Serum Hey, Cys-C and NAG, mALB, urinary Cr, mALB/urinary Cr in the severe preeclampsia group were higher than those in the preeclampsia mild group(P < 0.05). Serum Hey, Cys-C and NAG, mALB, urinary Cr, mALB/urinary Cr were higher in the mild preeclampsia group than in the gestational diabetes group, the difference was statistically significant(P < 0.05). Serum Hey, Cys-C and NAC, mALB, urinary Cr, mALB/urinary Cr were higher in the renal dysfunction group than in the normal renal function group(P < 0.05). The positive rates of serum Hey, Cys-C and NAG, mALB, urine Cr, mALB/urinary Cr were higher in the observation group than in the control group, and the difference was statistically significant(P < 0.05). The sensitivity and specificity of the combined detection were significantly higher than the single test, and the difference was statistically significant(P < 0.05). Conclusion Combined detection of serum Hey, CysC and NAG, mALB, urinary Cr, mALB/urinary Cr is beneficial for the diagnosis of early renal injury and is worthy of clinical promotion.