妊娠相关AKI患者Cys-C、SCr和NGAL水平变化及其在诊断和预后判断中的价值  

Changes of Cys-C,SCr and NGAL levels and their value in diagnosis and prognosis of patients with pregnancy associated AKI

作　　者：张瑞英 赵迅 王学敏[1] 苑玉聪[1] 王向托[1] 张晓艳[1] 

机构地区：[1]衡水哈励逊国际和平医院,河北衡水053000

出　　处：《中国妇幼健康研究》2017年第11期1395-1398,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的分析妊娠相关急性肾损伤(AKI)患者胱抑素C(Cys-C)、血清肌酐(SCr)与中性粒细胞明胶酶相关载脂蛋白(NGAL)水平变化及其在诊断与预后判断中的价值。方法选取衡水哈励逊国际和平医院2014年1月至2016年3月90例妊娠相关AKI患者为病例组,其中预后良好67例,预后不良23例,另选择同期90例正常分娩的产妇为对照组。在产后24h,对病例组与对照组产妇Cys-C、SCr和NGAL的水平进行检测,并且分别在产后6、12个月对病例组中预后良好组与预后不良组进行检测,同时分析妊娠相关AKI的影响因素。结果病例组产后24h时Cys-C、SCr和NGAL水平均较对照组高,差异均有统计学意义(t值分别为2.75、4.09、3.65,均P<0.05);产后6、12个月时,病例组中预后良好的产妇Cys-C、SCr和NGAL水平均明显低于预后不良的产妇,差异均有统计学意义(t值分别为2.83、2.92、3.52、3.49、3.12、3.36,均P<0.05)。Cys-C、SCr和NGAL均是影响妊娠相关AKI的独立危险因素(χ~2值分别为4.69、9.57、4.14,均P<0.05)。Cys-C、SCr和NGAL水平均是影响妊娠相关AKI预后不良的独立危险因素(χ~2值分别为4.74、30.25、25.72,均P<0.05)。结论妊娠相关AKI患者Cys-C、SCr和NGAL水平明显升高,三者在诊断与预后判断中均具有一定的评估价值。Objective To analyze the changes of cystatin C（Cys-C）,serum creatinine（SCr）and neutrophil gelatinase-associated lipoprotein（NGAL）levels and their value in diagnosis and prognosis of patients with pregnancy associated acute kidney injury（AKI）.Methods Ninety cases of pregnancy associated AKI from January 2014 to March 2016 were selected in case group in Harrison International Peace Hospital,including 67 cases of good prognosis and 23 cases of poor prognosis.And 90 cases of normal pregnant women were selected in control group in the same period.Cys-C,SCr and NGAL levels were detected in two groups within 24 hours after delivery,and those levels were decteced in good prognosis group and poor prognosis group at 6 and 12 months after delivery.The influencing factors of pregnancy associated AKI were analyzed.Results The Cys-C,SCr and NGAL levels in the case group were higher than those in the control group at 24 hours after delivery,which showed that the differences were statistically significant（t value was 2.75,4.09 and 3.65,respectively,all P〈0.05）.After 6 and 12 months after delivery,the CysC,SCr and NGAL levels in good prognosis group were significantly lower than those in poor prognosis group,which showed significant differences（t value was 2.83,2.92,3.52,3.49,3.12,and 3.36,respectively,all P〈0.05）.Cys-C,SCr and NGAL were independent risk factors of pregnancy related AKI（χ~2 value was 4.69,9.57 and 4.14,respectively,all P〈0.05）.Cys-C,SCr and NGAL were independent risk factors of poor prognosis in patients with pregnancy associated AKI（χ~2 value was 4.74,30.25 and 25.72,respectively,all P〈0.05）.Conclusion Cys-C,SCr and NGAL levels in patients with pregnancy associated AKI increase significantly,which has certain value in the diagnosis and prognosis of pregnancy associated AKI.

关 键 词：妊娠相关急性肾损伤 胱抑素C 血清肌酐 中性粒细胞明胶酶相关载脂蛋白 

分 类 号：R714.2[医药卫生—妇产科学]