血清Cys C、KIM-1、β2-MG对妊娠期高血压疾病患者肾损伤的诊断价值

Value of serum Cys C,KIM-1 and β2-MG levels for diagnosing renal injury of pregnant women with hypertensive disorder complicating pregnancy

目的:探究血清胱抑素C(Cys C)、尿肾损伤分子-1(KIM-1)、尿β2-微球蛋白(β2-MG)对妊娠期高血压疾病患者(HDCP)肾损伤的诊断价值。方法:回顾性分析2017年7月—2019年7月本院收治的妊娠期高血压疾病患者89例临床资料,按照病情严重程度分为子痫前期组(n=31)和妊娠期高血压疾病组(n=58),另选35例同期体检正常孕妇作为对照组,分析各组血清Cys C、KIM-1、β2-MG水平及对肾损伤的诊断价值。结果:子痫前期组24h尿蛋白量、肌酐清除率(Ccr)高于妊娠期高血压疾病组,Cys C、KIM-1、β2-MG水平妊娠期高血压疾病组均高于对照组,且子痫前期组高于妊娠期高血压疾病组(均P<0.05);Pearson相关性分析显示,Cys C、KIM-1、β2-MG与24h尿蛋白均呈正相关(r=0.796、0.638、0.579,P<0.05);Cys C、KIM-1、β2-MG诊断妊娠期高血压疾病肾损伤的AUC分别为0.847、0.852、0.878,其截断值分别为0.76mg/L、1.54mg/L、7.41ng/L,三者联合诊断具有最大的AUC,其敏感度(93.6%)、特异度(88.2%)和准确度(89.6%)最高。结论:血清Cys C、尿KIM-1及尿β2-MG能在一定程度上反映HDCP患者病情进展,联合检测对HDCP患者肾损伤具有较高的诊断效能。

Objective:To investigate the levels of serum cystatin C(Cys C),urinary kidney injury molecule-1(KIM-1),and urinaryβ2-microglobulin(β2-MG)for diagnosing renal injury of pregnant women with hypertensive disorder complicating pregnancy(HDCP).Methods:A retrospective analysis of pregnant women with HDCP from July 2017 to July 2019 was conducted.These women were divided into group A(31 women with preeclampsia)and group B(58 women with gestational hypertension)according to the severity of HDCP.In addition,35 normal pregnant women during the same period were selected in group C.The serum levels of Cys C,KIM-1,β2-MG of the women in the three groups were analyzed,and which’s diagnostic value for renal injury were also explored.Results:The 24h urinary protein value and Ccr level of the women in group A were significant higher than those of the women in group B.The levels of Cys C,KIM-1,andβ2-Mg of the women in group B were significant higher than those of the women in group C,and those of the women in group A were significant higher than those of the women in group B(all P<0.05).Pearson correlation analysis showed that the levels of Cys C,KIM-1,andβ2-MG were positively correlated with their 24h urinary protein value(r=0.796,0.638,0.579,P<0.05).The AUC of the levels of Cys C level,KIM-1 level,andβ2-MG level for diagnosing renal injury of the women with gestational hypertension were 0.847,0.852,and 0.878,respectively,and their cutoff values were 0.76 mg/L,1.54 mg/L and 7.41ng/L,respectively.The combined detection of Cys C,KIM-1,andβ2-MG levels for diagnosing renal injury had the highest AUC,the highest sensitivity(93.6%),the highest specificity(88.2%),and the highest accuracy(89.6%).Conclusion:The levels of serum Cys C,urinary KIM-1,and urinaryβ2-MG of pregnant women with HDCP can reflect their severity of HDCP,and the combined detection of Cys C,urinary KIM-1,and urinaryβ2-MG have high diagnostic efficacy for renal injury of pregnant women with HDCP.