随机尿白蛋白/肌酐比值对妊娠期高血压疾病的预测价值  

Predictive value of random spot albuminuria to creatinine ratio in women with hypertensive disorders complicating pregnancy

作　　者：阴红[1,2] 高云飞[1] 何淑明[2] 余艳萍[2] 黄启涛[1] 王艳[1] 孔紫靖[2] 钟梅[1] 

机构地区：[1]南方医科大学南方医院妇产科,广州市510515 [2]南方医科大学附属小榄医院妇产科,广东省中山市528415

出　　处：《实用医学杂志》2015年第9期1441-1443,共3页The Journal of Practical Medicine

基　　金：中山市科技局立项课题(编号:2014A1FC031)

摘　　要：目的:测定正常孕妇的随机尿白蛋白/肌酐比值(albuminuria to creatinine ratio,ACR),追踪妊娠结局,探讨ACR对妊娠期高血压疾病(hypertensive disorders complicating pregnancy,HDCP)的预测价值。方法:随机选择正常孕妇,纳入2 038例正常孕妇其中87例后期发生HDCP。测定ACR、血尿常规、血生化,尿蛋白阳性者测定24 h尿蛋白。结果:发生HDCP组ACR显著增高,24 h尿蛋白无明显差异;ACR与24h尿蛋白呈正相关;Losigtic回归分析显示年龄、孕周、ACR、红细胞、血糖、肌酐、总蛋白是发生HDCP的独立危险因素;ACR预测HDCP的ROC曲线下面积为0.787,敏感度为0.78,特异度为0.63,最佳值为1.46 mg/mmol。结论:ACR在HDCP前期与24 h尿蛋白呈正相关,较24 h尿蛋白敏感,可早期预测HDCP。Objective To determine the random spot albuminuria to creatinine ratio （ACR） of normal pregnant women , to track the pregnancy outcome , and to discuss the predictive value of ACR in women with hy-pertensive disorders complicating pregnancy （HDCP）. Methods Except for 87 pregnant women suffering from HDCP, 2 038 pregnant women were enrolled in this study. ACR, routine examinations of blood and urine, blood biochemical, 24-hr urinary protein were determined. Results ACR, but not 24-hr urinary protein level,was sig-nificantly higher in women with HDCP. There was positive correlation between the ACR and 24-hr urinary protein quantitation. Age, gestational weeks, ACR, red blood cells, fasting plasma glucose, serum creatinine, total pro-tein were the independent risk factors for HDCP. The sensitivity , specificity and optimal cut off value of ACR for predicting HDCP were 0.78, 0.63, 1.46 mg/mmol. Conclusions There was positive correlation between ACR and 24-hr urinary protein quantitation , and ACR provided a more sensitive pathway for early predictionof HDCP.

关 键 词：高血压 妊娠性 白蛋白尿 肌酸酐 尿分析 

分 类 号：R714.246[医药卫生—妇产科学]