血清胱抑素C及尿微量白蛋白对妊娠期高血压疾病孕妇肾脏损伤的评估价值

The value of serum cystatin C and uric microalbumin for evaluating the renal injury of pregnant women with hypertensive disorder complicating pregnancy

目的:分析血清胱抑素C及尿微量白蛋白对妊娠期高血压疾病孕妇肾脏损伤的评估价值。方法:选取本院妊娠期高血压疾病孕妇190例,分妊娠期高血压、轻度子痫前期及重度子痫前期各组,另选同期本院产前检查血压正常孕妇100例为对照组,检测各组血清胱抑素C及尿微量白蛋白水平,分析其水平与肾小球滤过率相关性和对肾脏功能损伤的预测效能。结果:与对照组比较,胱抑素C及尿微量白蛋白水平妊娠期高血压组、轻度子痫前期组及重度子痫前期组明显升高,且呈递增趋势(P均<0.05);肌酐及尿素氮水平轻度子痫前期组、重度子痫前期组高于对照组和妊娠期高血压组(P<0.05),而对照组及妊娠期高血压组无差异(P>0.05);胱抑素C及尿微量白蛋白水平与肾小球滤过率均存在相关性(r=-0.885、-0.943,P<0.001),两项指标对肾脏损伤均具有预测能力,AUC分别为0.814、0.747,灵敏度84.4%、82.6%,特异性72.9%、75.7%。结论:血清胱抑素C及尿微量白蛋白均可作为妊娠期高血压疾病孕妇肾脏功能的早期监测指标。

Objective: To evaluate value of serum cystatin C and uric microalbumin for evaluating the renal injury of pregnant women with hypertensive disorder complicating pregnancy. Methods: 190 pregnant women with hypertensive disorder complicating pregnancy were selected as the subjects, and were divided into group A (women with gestational hypertension, group B (women with mild preeclampsia), and group B (women with severe preeclampsia), and another 100 healthy pregannat women were selected in group D during the same period. The serum levels of cystatin C and uric microalbumin of women in the four groups were detected. The levels of serum cystatin C and uric microalbumin, and glomerular filtration rate of all women for predicting their renal function injury was analyzed. Results: Among the four group, the levels of cystatin C and uric microalbumin of women in the group C were the lowest, those of women in group C were the highest, and those of women in group B were the second highest ( P <0.05). The levels of creatinine and urea nitrogen of women in group B and C were significant higher than those of women in group A and D ( P < 0.05 ), but there were no significant difference in creatinine and urea nitrogen levels between group A and group D ( P >0.05). The cystatin C level and uric microalbumin level of pregnant women were correlated with their glomerular filtration rate ( r=- 0.885 ,-0.943, P <0.001), and both of them could predict renal injury of pregnant women ( P < 0.001 ). The AUC, sensitivity, and specificity of cystatin C level for predicting renal injury were 0.814, 84.4%, and 72.9%, respectively. The AUC, sensitivity and specificity of uric microalbumin level for predicting renal injury were 0.747 , 82.6%, and 75.7%, respectively. Conclusion: The serum levels of cystatin C and uric microalbumin can be used as early monitoring indexes of renal function of pregnant women with hypertensive disorder complicating pregnancy.