尿NAG、MALB和RBP联合检测在重度子痫前期患者中的临床价值  

Clinical value of combined detection of urinary NAG,MALB,and RBP in patients with severe preeclampsia

作　　者：张舒[1] 王艳艳[1] 田琦[2] 田庚[1] 韩笑[1] 周顺卿[1] 

机构地区：[1]吉林大学第二医院妇产科,吉林长春130041 [2]吉林省肿瘤医院,吉林长春130021

出　　处：《中国妇幼保健》2016年第17期3481-3483,共3页Maternal and Child Health Care of China

摘　　要：目的探讨尿N-乙酰β-D氨基葡萄糖苷酶(u NAG)、尿微量白蛋白(u MALB)和视黄醇结合蛋白(uRBP)的联合检测对重度子痫前期患者早期肾损伤的临床诊断及预后评估的应用价值。方法选择28例子痫前期孕妇为观察组,同期20例正常孕妇为对照组,于入院24 h内监测各组孕妇尿液中u Cr、UA、u NAG、u MALB、uRBP的浓度及妊娠期高血压患者产后42 d复查时尿液中u NAG、u MALB、uRBP的浓度。结果与正常妊娠组比较,入院24 h内重度子痫前期组u Cr、UA、u NAG、u MALB、uRBP值均显著增高(P<0.05);与重度子痫前期组比较,产后42 d妊娠期高血压复查组患者u MALB、u NAG值均显著降低(P<0.05);u NAG、u MALB和uRBP联合检测的敏感性和特异性大于单个指标检测的灵敏度与特异性。结论 uRBP、u MALB和u NAG可作为监测妊娠期高血压疾病患者早期肾损伤的敏感指标,联合检测u MALB、uRBP与u NAG对妊娠期高血压疾病孕妇早期肾损伤的预防,尤其是对肾小球或肾小管的损害定位有一定的临床意义。Objective To explore the application value of combined detection of urinary N-acetyl-β-D-glucosaminidase （ uNAG）, urinary microalbuminuria （uMALB）, and urinary retinol binding protein （uRBP） in clinical diagnosis and prognosis evaluation of early kid- ney injury among the patients with severe preeclampsia. Methods Twenty-eight pregnant women with preeclampsia were selected as observation group, twenty normal pregnant women during the same period were selected as observation group. The concentrations of uCr, UA, uNAG, uMALB, and uRBP in the two groups were monitored within 24 hours after admission to hospotial; the concentrations of uNAG, uMALB, and uRBP among patients with hypertensive disorder complicating pregnancy （HDCP） at 42 days after delivery were reexamined. Results Compared with normal pregnancy group, the concentrations of uCr, UA, uNAG, uMALB, and uRBP in severe preeclampsia group within 24 hours after admission to hospotial increased significantly （P〈0. 05 ） ; compared with severe preeclampsia group, the concentrations of uMALB and uNAG in HDCP reexamination group at 42 days after delivery decreased significantly （ P〈0. 05 ） ; the sensitivity and specificity of combined detection of uNAG, uMALB, and uRBP were higher than those of single index detection. Conclusion uRBP, uMALB, and uNAG can be used as sensitive indicators of early kidney injury among pregnant women with HDCP ; combined detection of uMALB, uRBP, and uNAG has a certain clinical significance in preventing early kidney injury among pregnant women with HDCP, especially in localization of renal glomerular or renal tubular damage.

关 键 词：尿N-乙酰β-D氨基葡萄糖苷酶 尿微量白蛋白 尿视黄醇结合蛋白 重度子痫前期 早期肾损伤 

分 类 号：R714.245[医药卫生—妇产科学]