血清sEng、sFlt-1和Cys C在妊娠期高血压疾病肾功能损害中的临床诊断价值

Clinical diagnostic value of serum sEng,sFlt-1 and Cys C in renal dysfunction in hypertensive disorders complicating pregnancy

目的观察血清可溶性内皮因子(sEng)、可溶性内皮生长因子受体-1(sFlt-1)和胱抑素C(Cys C)在妊娠期高血压疾病(HDCP)肾功能损害中的临床诊断价值。方法选择2020年1月至2021年12月该院诊治的HDCP患者118例为HDCP组;选择同期行妊娠体检者(75例)和健康体检者(65例),为妊娠组和对照组。观察三组血清sEng、sFlt-1、Cys C和β_(2)-微球蛋白(β_(2)-MG)水平的变化,血清sEng、sFlt-1、Cys C和β_(2)-MG水平与HDCP严重程度和肾功能损害的关系,及其在HDCP的肾功能损害的诊断效能。结果血清sEng、sFlt-1、Cys C和β_(2)-MG水平明显高于妊娠组和对照组(P<0.01),而妊娠组妊娠组明显高于对照组(P<0.01)。血清sEng、sFlt-1、Cys C和β_(2)-MG水平随着HDCP严重程度的升高而升高(P<0.01)。HDCP患者血清sEng、sFlt-1、Cys C和β_(2)-MG水平肾功能异常组明显高于肾功能妊娠组组(P<0.01)。血清sEng、sFlt-1和Cys C水平在预测HDCP患者发生肾功能异常具有较高的诊断效能明显高于β_(2)-MG(P<0.05),联合检测的灵敏度为90.2%,特异度为93.5%,AUC为0.972明显高于单个指标sEng(Z=3.381,P<0.01)、sFlt-1(Z=3.276,P<0.01)和Cys C(Z=3.825,P<0.01),而三个指标之间的AUC比较差异无统计学意义(P>0.05)。结论血清sEng、sFlt-1和Cys C水平是HDCP疾病严重程度的指标,联合检测有助于诊断HDCP患者的肾功能损伤。

Objective To observe the clinical diagnostic value of the serum soluble endoglin(sEng),soluble vascular endothelial growth factor receptor 1(sFlt-1)and cystatin C(Cys C)in the renal function impairment of hypertensive disorders complicating pregnancy(HDCP).Methods A total of 118 patients with HDCP who were diagnosed and treated in the hospital from January 2020 to December 2021 were selected as the HDCP group;the pregnancy physical examination(75 cases)and healthy physical examinations(65 cases)in the hospital during the same period were selected as pregnant group and control group.The serum levels of sEng,sFlt-1,Cys C andβ_(2)-microglobulin(β_(2)-MG)were compared among three group,the relationship among the serum sEng,sFlt-1,Cys C and β_(2)-MG levels,the HDCP severity and renal impairment was observed,and its diagnostic efficacy of renal impairment was also observed.Results The serum levels of sEng,sFlt-1,Cys C and β_(2)-MG were significantly higher than those in the pregnancy group and the control group(P<0.01),while those in the pregnancy group was significantly higher compared with the control group(P<0.01).The serum levels of sEng,sFlt-1,Cys C and β_(2)-MG increased with the severity of HDCP(P<0.01).The serum levels of sEng,sFlt-1,Cys C and β_(2)-MG in HDCP patients in the renal function group were significantly higher than those in the renal function group(P<0.01).The serum sEng,sFlt-1 and Cys C levels had higher diagnostic efficacy in predicting renal dysfunction in patients with HDCP than β_(2)-MG(P<0.05).The sensitivity of combined detection was 90.2%,specificity was 93.5%,AUC was 0.972 which was significantly higher than that of the single indicators sEng(Z=3.278,P<0.01),sFlt-1(Z=3.393,P<0.01)and Cys C(Z=3.721,P<0.01),while there was no statistically significant difference in AUC among the three indicators(P>0.05).Conclusion The serum levels of sEng,sFlt-1 and Cys C are indicators of the HDCP severity,and the combined detection is helpful for the diagnosis of renal function damage in patients with HDCP.