血清同型半胱氨酸、中性粒细胞明胶酶相关脂质运载蛋白联合尿微量白蛋白对妊娠期高血压疾病患者早期肾损伤的诊断价值  

Diagnostic value of serum homocysteine,neutrophil gelatinase-associated lipid carrier protein and urinary microalbumin for early renal injury of patients with hypertensive disease of pregnancy

作　　者：张莉莉[1] 关丫丫 张林波 ZHANG Lili;GUAN Yaya;ZHANG Linbo(Department of Clinical Laboratory,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)

机构地区：[1]新乡医学院第三附属医院检验科,河南新乡453003

出　　处：《新乡医学院学报》2022年第2期177-181,共5页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20190497);新乡医学院海外归国博士启动金项目(编号:505098)。

摘　　要：目的探讨血清同型半胱氨酸(HCY)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和尿微量白蛋白(U-mAlb)对妊娠期高血压疾病(HDP)患者早期肾损伤的诊断价值。方法选择2018年11月至2020年7月新乡医学院第三附属医院收治的HDP患者182例为HDP组,根据高血压程度将HDP患者分为妊娠期高血压组(n=61)、子痫前期轻度组(n=59)、子痫前期重度组(n=62),根据肌酐清除率将HDP患者分为肾功能正常组(n=88)和肾功能异常组(n=94);另选择同期来院进行产检的正常妊娠孕妇177例为正常对照组。采用酶循环法检测血清HCY水平,酶联免疫分析法检测血清NGAL水平,乳胶增强免疫比浊法检测尿样中U-mAlb水平,应用受试者工作特征(ROC)曲线分析HCY、NGAL、U-mAlb单独检测及三者联合检测对HDP早期肾损伤的诊断价值。结果HDP组患者血清HCY、NGAL和U-mAlb水平显著高于正常对照组(P<0.05);子痫前期重度组患者血清HCY、NGAL和U-mAlb水平显著高于子痫前期轻度组和妊娠期高血压组,子痫前期轻度组患者血清HCY、NGAL和U-mAlb水平显著高于妊娠期高血压组(P<0.05)。肾功能异常组患者血清HCY、NGAL和U-mAlb水平显著高于肾功能正常组(P<0.05)。HCY、NGAL、U-mAlb诊断HDP早期肾损伤的临界值分别为14.65μmol·L^(-1)、13.27μg·L^(-1)、87.21 mg·L^(-1)。HCY、NGAL、U-mAlb单独检测诊断HDP早期肾损伤ROC曲线下面积(AUC)比较差异无统计学意义(P>0.05)。HCY、U-mAlb单独检测诊断HDP早期肾损伤的灵敏度大于NGAL(P<0.05),HCY、U-mAlb单独检测诊断HDP早期肾功能损伤的灵敏度比较差异无统计学意义(P>0.05)。HCY单独检测诊断HDP早期肾功能损伤的特异度小于NGAL和U-mAlb(P<0.05),NGAL单独检测与U-mAlb单独检测诊断HDP早期肾损伤的特异度比较差异无统计学意义(P>0.05)。HCY、NGAL、U-mAlb联合检测诊断HDP早期肾损伤的AUC、灵敏度和特异度大于HCY、NGAL、U-mAlb单独检测(P<0.05)。结论妊娠�Objective To explore the diagnostic value of serum homocysteine(HCY),neutrophil gelatinase-associated lipid carrier protein(NGAL)and urinary microalbumin(U-mAlb)for early renal injury of patients with hypertensive disease of pregnancy(HDP).Methods A total of 182 patients with HDP admitted to the Third Affiliated Hospital of Xinxiang Medical University from November 2018 to July 2020 were selected as the HDP group,they were divided into gestational hypertension group(n=61),mild preeclampsia group(n=59)and severe preeclampsia group(n=62)according to the degree of hypertension,and they were divided into normal renal function group(n=88)and abnormal renal function group(n=94)according to creatinine clearance rates.In addition,a total of 177 normal pregnant women who came to our hospital for labor examination during the same period were selected as the normal control group.The serum HCY level was detected by enzyme circulation method,the serum NGAL level was detected by enzyme-linked immunosorbent assay,and the U-mAlb level in urine was detected by latex enhanced immunoturbidimetry.The diagnostic value of single detection of HCY,NGAL,U-mAlb and their combined detection for early renal injury of gestational hypertension was analyzed by receiver operating characteristic(ROC)curve.Results The levels of HCY,NGAL in serum and U-mAlb of patients in the HDP group were significantly higher than those in the normal control group(P<0.05).The levels of HCY,NGAL in serum and U-mAlb of patients in the severe preeclampsia group were significantly higher than those in the mild preeclampsia group and gestational hypertension group,the levels of HCY,NGAL in serum and U-mAlb of patients in the mild preeclampsia group were significantly higher than those in the gestational hypertension group(P<0.05).The critical values of HCY,NGAL and U-mAlb in diagnosing the early renal injury of patients with HDP were 14.65μmol·L^(-1),13.27μg·L^(-1),87.21 mg·L^(-1),respectively.There was no significantly difference in the area under curve(AUC)of

关 键 词：妊娠期高血压疾病 早期肾损伤 同型半胱氨酸 中性粒细胞明胶酶相关脂质运载蛋白 尿微量白蛋白 

分 类 号：R714.246[医药卫生—妇产科学]