尿IgG、mALB、β2-MG联合ACR预测妊娠期糖尿病孕妇早期肾功能损伤  

Predictive value of urine immunoglobulin, microalbumin,β2-microglobulin, and urinary albumin/creatinine ratio of women with gestational diabetes mellitus for their early impairment of renal function

作　　者：曾瑜[1] 夏航彪 韩雨梅[1] 徐泽娟 杨堃[1] ZENG Yu;XIA Hangbiao;HAN Yumei;XU Zejuan;YANG Kun(Suining Central Hospital,Suining.Sichuan Province,629000;Nanhe Women's and Children's Branch Hospital of Guangyuan City Central Hospital,Guangyuan,Sichuan Province)

机构地区：[1]四川省遂宁市中心医院,629000 [2]四川省广元市中心医院南河妇女儿童分院

出　　处：《中国计划生育学杂志》2022年第7期1644-1647,共4页Chinese Journal of Family Planning

基　　金：遂宁市中心医院科研课题(2019Y58)。

摘　　要：目的:探究尿免疫球蛋白(IgG)、微量白蛋白(mALB)、β2微球蛋白(β2-MG)联合尿微量白蛋白与尿肌酐比值(ACR)对妊娠糖尿病早期肾功能损伤的预测价值.方法:选取2019年1月-2020年3月本院收治的90例妊娠期糖尿病(GDM)患者为GDM组,同期90例健康妊娠孕妇(正常妊娠组)和90例未孕健康女性(未孕组),根据肾生化指标将GDM组分为肾功能正常和肾功能损伤组,检测比较各组IgG、mALB、β2-MG、ACR水平,采用受试者工作特征曲线(ROC)分析各指标预测GDM早期肾功能损伤价值.结果:尿IgG、mALB、β2-MG及ACR水平在GDM组、正常妊娠组、未孕组依次降低,且GDM组肾功能损伤患者高于肾功能损伤正常患者(均P<0.05).ROC曲线分析,尿IgG、mALB、β2-MG及ACR预测GDM早期肾功能损伤的曲线下面积(AUC)分别为0.786、0.832、0.841和0.853,灵敏度分别为74.1%、75.0%、75.4%和80.4%;特异度分别为69.4%、73.5%、75.5%和85.3%,4项联合的AUC为0.946,灵敏度96.4%,特异度97.4%.结论:GDM孕妇早期尿IgG、mALB、β2-MG、联合ACR出现异常,该4项指标有助于发现患者早期肾功能损伤,4项联合检测诊断效能最高.Objective: To explore the predictive value of urinary immunoglobulin(IgG), microalbumin(mALB),β2-microglobulin(β2-MG), and urinary albumin/creatinine ratio(ACR) of pregnant women with gestational diabetes mellitus(GDM) for their early impairment of renal function. Methods: A total of 90 pregnant women with GDM were selected in group A, 90 healthy pregnant women were selected in group B, and 90 healthy women without pregnancy were selected in group C from January 2019 to March 2020. The women in group A were further divided into group A1(women with normal renal function) and group A2(women with impairment of renal function) based on the renal biochemistry indexes of the women. The levels of IgG, mALB, β2-MG, and ACR of the women were detected and compared among these groups. The predictive value of IgG, mALB, β2-MG, and ACR of the women with GDM for their early impairment of renal function was analyzed by receiver operating characteristic curve(ROC). Results: The levels of urinary IgG, mALB, β 2-Mg, and ACR of the women in group A, group B, and group C had decreased gradually, and which of the women in group A2 were significantly higher than those of the women in group A1(all P<0.05). ROC curve analysis showed that the area under curve(AUC) of urinary IgG, mALB, β2-MG, and ACR of the women with GDM for predicting their early renal function impairment were 0.786, 0.832, 0.841, and 0.853, respectively, the sensitivities of which were 74.1%, 75.0%, 75.4%, and 80.4%, respectively, and the specificity of which w was 69.4%, 73.5%, 75.5% and 85.3%, respectively. The AUC, the sensitivity, and the specificity of the combination the levels of urinary IgG, mALB, β 2-Mg, and ACR of the women with GDM for predicting their early renal function impairment were 0.946, 96.4%, and 97.4%, respectively. Conclusion: The levels of urinary IgG, mALB, β2-MG, and ACR of the pregnant women with GDM increase abnormally,which are all helpful to predict the early renal function impairment of the women.The combination the levels of uri

关 键 词：妊娠期糖尿病 早期肾功能损伤 尿免疫球蛋白 尿微量白蛋白 预测 

分 类 号：R714.256[医药卫生—妇产科学]