广州市海珠区妊娠妇女血清肾功能3项的检测和参考区间建立

Detection of 3 serum indicators of renal function in pregnant women at Haizhu District,Guangzhou and establishment of their reference intervals

目的检测和分析海珠区健康妊娠妇女在不同孕期间肾功能3项(Crea、Urea和UA)测量结果,并建立其参考区间。方法回顾分析2018年1月至2019年12月在广州市海珠区妇幼保健院接受孕检、产检的健康妊娠期妇女血清肾功能3项检测结果。根据CLSI C28-A3文件要求,分析不同年龄和不同孕期等进行统计学分析,建立其参考区间。结果肾功能3项结果均与正常人群参考区间有差别,与未怀孕的女性相比,肌酐和尿素从妊娠早中期逐渐下降,直至孕晚期和分娩期上升,而尿酸逐步升高;建议本地区孕妇参考区间根据不同孕周进行设置,Crea和Urea分别为1~12周:32.0~61.0μmol/L、1.9~4.5 mmol/L;13~40周:30.0~54.0μmol/L、1.7~4.7 mmol/L;分娩期:30.0~62.0μmol/L、1.9~5.5 mmol/L;尿酸为1~20周:147.0~376.0μmol/L;21~34周:169.0~395.0μmol/L;35周至分娩期:193.0~548.0μmol/L。结论肾功能检测项目在孕期呈现不同变化,实验室应建立或验证适合本地区人群的参考区间,有助于临床诊断。

Objective To analyze the results of renal function,including creatinine,urea,and uric acid,of healthy pregnant women at Haizhu District during different pregnancy periods,and to establish reference intervals of the 3 indicators.Methods The results of the 3 indicators in the healthy pregnant women who received pregnancy and delivery tests in Haizhu Maternal and Child Health Hospital from January,2018 to December,2019 were retrospectively analyzed.The correlation between different ages and different gestation periods was statistically analyzed,and the reference intervals were established.Results The three indicators for renal function in healthy pregnant women were different from the reference intervals of the normal population.Compared with those of the non-pregnant women,the creatinine and urea concentrations of the pregnant women decreased from early pregnancy to until delivery,while the uric acid concentration showed an increasing trend.It is recommended that the reference intervals for the 3 indicators for pregnant women in the district should be establish according to different gestational weeks.The reference intervals for creatinine and urea concentrations were32.0-61.0μmol/L and 1.9-4.5 mmol/L when they were 1-12 weeks pregnant;30.0-54.0μmol/L and 1.7-4.7 mmol/L when they were13-40 weeks pregnant;and 30.0-62.0μmol/L and 1.9-5.5 mmol/L when they deliver.The reference intervals for uric acid concentration was 147.0-376.0μmol/L when they were 1-20 weeks pregnant;169.0-395.0μmol/L when they were 21-34 weeks pregnant;and 193.0-548.0μmol/L from 35 weeks pregnancy to delivery.Conclusion There are different changes in the three indicators during pregnancy.The laboratory should establish or verify reference intervals suitable for the population in this district,which is helpful for clinical diagnosis.