血清Hcy、Cys-C和hs-CRP对妊娠期高血压疾病患者肾损伤的评估价值

The application value of serum homocysteine,Cystatin C and hs-CRP in evaluating the renal injury of patients with gestational hypertension

目的探讨血清同型半胱氨酸(Hcy)、胱抑素C(Cys-C)、超敏C-反应蛋白(hs-CRP)对妊娠期高血压疾病患者肾损伤的评估价值。方法188例妊娠期高血压疾病患者纳入研究,根据不同类型,分为重度子痫前期组(n=58),子痫前期组(n=64),妊娠期高血压组(n=66)。另外选取75例同期健康妊娠期女性作为对照组。比较4组Hcy、Cys-C、hs-CRP、肌酐(Crea)、尿酸(UA)、血尿素氮(BUN)、肾水球滤过率(GFR)水平。结果研究组Cys-C、Hcy及hs-CRP水平均明显高于对照组(P<0.05)。妊娠期高血压组,子痫前期组,重度子痫前期组患者Cys-C、Hcy及hs-CRP水平依次明显升高(P<0.05)。妊娠高血压组、对照组LIA、BUN水平均低于重度子痫前期组,重度子痫前期组Crea水平高于子痫前期组、妊娠高血压组、对照组,差异均有统计学意义(P<0.05)。Cys-C、Hcy及hs-CRP水平均与GFR呈负相关(r=-0.588、-0.466、-0.368,P<0.05)。结论Cys-C、Hcy及hs-CRP水平能够更灵敏、有效地反映妊娠期高血压疾病患者早期肾功能损伤情况,为临床干预和治疗提供依据。

Objective To investigate the application value of serum homocysteine(Hcy),Cystatin C(Cys-C)and high sensitivity C-reactive protein(hs-CRP)in evaluating the renal injury of patients with gestational hypertension.Methods A total of 188 patients with gestational hypertension were enrolled in the study.According to different disease type,these patients were divided into severe preeclampsia group(n=58),preeclampsia group(n=64)and gestational hypertension group(n=66),at the same time,the other 75 healthy pregnant women were enrolled as control group.The levels of Hcy,Cys-C,hs-CRP,Crea,UA,BUN and GFR were observed and compared among groups.Results The levels of Cys-C,Hcy and hs-CRP in case group were significantly higher than those in control group(P<0.05).The levels of Cys-C,Hcy and hs-CRP in gestational hypertension group,preeclampsia group and severe preeclampsia group were significantly increased in turn(P<0.05).Moreover the levels of LIA and BUN in gestational hypertension group and control group were significantly lower than those in severe preeclampsia group,however,the levels of Crea in severe preeclampsia group were significantly higher than those in the other three groups(P<0.05).in addition the levels of Cys-C,Hcy and hs-CRP were negatively correlated with those of GFR(P<0.05).Conclusion The detection of the levels of Cys-C,Hcy and hs-CRP can more sensitively and effectively reflect the early renal function damage in patients with gestational hypertension,which can provide basis for clinical intervention and treatment.