血清淀粉样蛋白A视黄醇结合蛋白和尿β2微球蛋白在妊娠期高血压疾病早期肾损伤中的诊断价值  

The Diagnostic Value of Serum Amyloid A,Retinol Binding Protein and Urine β2 Microglobulin in Early Renal Injury During Pregnancy Hypertension

作　　者：舒银珍 全晖 曾志荣 黄琦 蔡明燕 SHU Yinzhen;QUAN Hui;ZENG Zhirong(The Second Affiliated Hospital of Chengdu Medical College/China National Nuclear Corporation 416 Hospital,Sichuan Chengdu 610051,China)

机构地区：[1]成都医学院第二附属医院/核工业四一六医院,四川成都610051

出　　处：《河北医学》2022年第1期66-71,共6页Hebei Medicine

基　　金：四川省医学会科研课题,(编号:2019TG20)。

摘　　要：目的:分析血清淀粉样蛋白A(SAA)、视黄醇结合蛋白(RBP)和尿β2微球蛋白(β2-MG)在妊娠期高血压疾病(HDP)早期肾损伤中的诊断价值。方法:选取2019年3月至2021年3月在本院住院治疗的孕周为20~40周的HDP患者120例,根据病情严重程度分为轻度组32例,中度组53例及重度组35例;另外选取50名同期入院产检的正常孕妇为对照组。收集清晨空腹肘静脉血3mL及中段尿5mL,膀胱排空后收集24h尿液。比较四组血清SAA、RBP和尿β2-MG及24h尿蛋白的差异;并采用受试者操作特征曲线(ROC)分析各个指标对HDP早期肾损伤的诊断价值。结果:血清SAA、RBP和尿β2-MG平均水平在对照组、轻度组、中度组、重度组中逐渐升高,任意两组间的差异均有统计学意义(P<0.05);血清SAA、RBP、尿β2-MG与24h尿蛋白水平均呈现出正相关性(r=0.751、0.878、0.668,P<0.05);血清SAA、RBP和尿β2-MG联合检测诊断HDP的ROC曲线下面积(AUC)为0.969,灵敏度为0.927,特异度为0.980。结论:血清SAA、RBP和尿β2-MG水平可以在一定程度上反映HDP患者的肾损伤程度,通过联合检测能提高HDP患者早期肾损害诊断的灵敏度和特异度,对发现HDP患者早期肾损害和评估疾病的进展程度有较大的价值。Objective:To analyze the diagnostic value of serum amyloid protein A(SAA),retinol binding protein(RBP)and urine beta 2 microglobulin(β2-MG)in early renal injury during pregnancy hypertension disease(HDP).Methods:120 HDP patients with gestational age of 20~40 weeks in our hospital from March 2019 to March 2021 were selected and divided into mild group(32 cases),moderate group(53 cases)and severe group(35 cases)according to the severity of the disease.In addition,50 normal pregnant women hospitalized in the same period were selected as the control group.3 ml of fasting elbow venous blood and 5 ml of midstream urine were collected in the morning.24 h urine was collected after bladder emptying.The levels of SAA,RBP and urine were compared among the four groups.Receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of each index for early renal injury of HDP.Results:Serum SAA,RBP and urineβ2-MG averages increased gradually in the control group,mild group,moderate group,and severe group,and the differences between any two groups were statistically significant(P<0.05).There was a positive correlation between serum SAA,RBP,or urineβ2-MG and 24h urinary protein level(r=0.751、0.878、0.668,P<0.05).The combined detection of serum SAA,RBP and urineβ2-MG had an ROC curve area(AUC)of 0.918,a sensitivity of 0.895 and a specificity of 0.933 to predict HDP.Conclusion:Serum SAA,RBP and urineβ2-MG levels can reflect the degree of kidney damage in HDP patients to a certain extent.Joint testing can improve the sensitivity and specificity of early kidney damage diagnosis in HDP patients,and it has great value for the diagnosis and assessment of the early kidney damage in HDP patients.

关 键 词：妊娠期高血压疾病 早期肾损伤 血清淀粉样蛋白A 视黄醇结合蛋白 尿Β2微球蛋白 

分 类 号：R714.246[医药卫生—妇产科学]