子痫前期与妊娠合并慢性肾脏病孕妇血清及尿液β2-微球蛋白水平的比较  

Comparison of Serum and Urinary β2-microglobulin in Preeclampsia and Pregnancies Complicated with Chronic Kidney Disease

作　　者：庄旭[1] 陆漪婷 丁立[3] 陈云燕[1] 林建华[1] ZHUANG Xu;LU Yiting;DING Li(Renji Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China Department of Obstetrics and Gynecology,Shanghai 200127, China;Renji Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China Department of Laboratory Medicine,Shanghai 200127, China;Renji Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China Department of Nephrology,Shanghai 200127, China)

机构地区：[1]上海交通大学医学院附属仁济医院妇产科,上海200127 [2]上海交通大学医学院附属仁济医院检验科,上海200127 [3]上海交通大学医学院附属仁济医院肾脏内科,上海200127

出　　处：《实用妇产科杂志》2019年第1期45-49,共5页Journal of Practical Obstetrics and Gynecology

基　　金：国家科技部"十二五"支撑计划(编号:2014BAI05B05)

摘　　要：目的:比较子痫前期(PE)与妊娠合并慢性肾脏病孕妇血清和尿液β2-微球蛋白(β2-MG)的差异以及初步研究正常孕妇参考值。方法:收集2017年2月至2018年1月住院的孕妇共149例,其中PE孕妇(PE组) 42例(28. 2%),妊娠合并慢性肾脏病孕妇(肾脏病组) 53例(35. 6%),正常孕妇(对照组) 54例(36. 2%),分别检测其血清及尿液中β2-MG水平。结果:(1)肾脏病组孕妇尿液β2-MG水平明显高于PE组及对照组孕妇(P<0. 01),而PE组和对照组孕妇尿液β2-MG水平差异无统计学意义(P=0. 980)(分别为5. 97±11. 26 mg/L、0. 33±0. 12 mg/L、0. 36±0. 13 mg/L)。(2)肾脏病组孕妇血清β2-MG水平明显高于PE组及对照组孕妇(P<0. 01),而PE组和对照组孕妇血清β2-MG水平差异无统计学意义(P=0. 068)(分别为3. 98±3. 40 mg/L、2. 76±0. 60 mg/L、1. 98±0. 79 mg/L)。(3)将血清及尿液β2-MG值纳入ROC曲线,并计算AUC值后初步发现尿液β2-MG相应的AUC为0. 652(P=0. 002),正常孕妇尿液β2-MG水平参考值为0～0. 51 mg/L;血清β2-MG相应的AUC为0. 843(P<0. 01),正常孕妇血清β2-MG水平参考值为0～2. 35 mg/L。(4)PE组尿液β2-MG阴性及血清β2-MG阳性患者共31例,占73. 8%(31/42),无单纯尿液β2-MG阳性患者。结论:PE与妊娠合并慢性肾脏病孕妇的血清及尿液β2-MG水平存在明显差异,建议重新定义正常孕妇的血清及尿液β2-MG参考值。Objective: To study the difference of serum and urinary β2-microglobulin in pre-eclampsia( PE)and pregnancies complicated with chronic kidney disease. Methods: 42( 28. 2%) pregnancies with PE( PE group),53( 35. 6%) pregnancies with chronic kidney disease( chronic kidney disease group) and 54( 36. 2%)normal pregnancies( control group) delivered in our hospital were resuicted in this study from February 2017 to January 2018.Serum and urinary β2-microglobulin were detected to know their expression characteristics in pregnancies with PE and with chronic kidney disease.Results:(1)Urinary β2-globulin in chronic kidney disease group was significantly higher than those in PE and control groups( 5. 97±11. 26 mg/L vs 0. 33±0. 12 mg/L vs 0. 36±0. 13 mg/L,P<0. 01).(2)Serum β2-globulin in chronic kidney disease group was significantly higher than those in PE and control groups( 3. 98±3. 40 mg/L vs 2. 76±0. 60 mg/L vs 1. 98±0. 79 mg/L,P<0. 01).(3)All serum and urinary β2-globulin values were taken into ROC and the corresponding AUC was calculated.The AUC of urinaryβ2-globulin was 0. 652,with a reference value of 0-0. 51mg/L in normal pregnancies.The AUC of serum β2-globulin was 0. 843,with a reference value of 0-2. 35mg/L in normal pregnancies.(4) 73. 8% PE showed increased serum β2-globulin with normal urinary β2-globulin and simply increased urinary β2-globulin was not detected.Conclusions: The serum and urinary levels of β2-microglobulin in pregnancies with PE and with chronic kidney disease are significantly different. Meanwhile it was recommended that the reference values of serum and urinaryβ2-globulin in pregnancy should be re-defined.

关 键 词：子痫前期 妊娠合并慢性肾脏病 尿液β2-微球蛋白 血清Β2-微球蛋白 

分 类 号：R714.244[医药卫生—妇产科学]