UACR、尿RBP及血清PAPP-A对GDM肾损伤的诊断价值  

Diagnostic value of UACR,urinary RBP and serum PAPP-A for renal injury in patients with GDM

作　　者：王泯蓉 沈娟[1] 赵菊惠 WANG Minrong;SHEN Juan;ZHAO Juhui(Department of Obstetrics and Gynecology,Mianyang Central Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]四川省绵阳市中心医院妇产科,四川绵阳621000

出　　处：《国际检验医学杂志》2022年第23期2929-2932,共4页International Journal of Laboratory Medicine

摘　　要：目的探讨尿微量清蛋白与尿肌酐比值(UACR)、尿视黄醇结合蛋白(RBP)及血清妊娠相关血浆蛋白A(PAPP-A)对妊娠期糖尿病(GDM)肾损伤的诊断价值。方法选取2020年1月至2021年1月该院产科收治的118例GDM孕妇作为研究对象,根据内生肌酐清除率(Ccr)水平将所有孕妇划分为非肾损伤组(Ccr≥80 mL/min)78例和肾损伤组(Ccr<80 mL/min)40例,另选取同期产检健康孕妇50例作为对照组。检测尿微量清蛋白和尿肌酐水平,计算UACR;采用胶乳增强免疫比浊法检测尿RBP水平;采用酶联免疫吸附试验检测血清PAPP-A水平。比较3组UACR、尿RBP、血清PAPP-A水平;分析UACR、尿RBP及血清PAPP-A水平与GDM肾损伤的线性关系;分析UACR、尿RBP及血清PAPP-A对GDM肾损伤的诊断效能。结果肾损伤组UACR、尿RBP水平高于非肾损伤组及对照组,血清PAPP-A水平低于非肾损伤组及对照组,非肾损伤组UACR、尿RBP水平高于对照组,血清PAPP-A水平低于对照组,差异有统计学意义(P<0.05)。多元线性回归分析结果显示,UACR、尿RBP和血清PAPP-A与GDM肾损伤存在线性相关(P<0.05)。UACR、尿RBP、血清PAPP-A单独及联合检测诊断GDM肾损伤的灵敏度分别为92.50%、85.00%、47.50%、97.60%,特异度分别为98.70%、100.00%、97.40%、92.00%,曲线下面积分别为0.965、0.924、0.744、0.984。结论GDM肾损伤患者UACR、尿RBP水平升高,血清PAPP-A水平降低,上述3项指标与GDM患者肾损伤密切相关,还可用于GDM肾损伤的辅助诊断,有助于指导临床诊疗。Objective To investigate the diagnostic value of urinary microalbumin to urinary creatinine ratio(UACR),urinary retinol-binding protein(RBP)and serum pregnancy-associated plasma protein A(PAPP-A)for renal injury in gestational diabetes mellitus(GDM).Methods A total of 118 pregnant women with GDM admitted to the department of obstetrics of the hospital from January 2020 to January 2021 were selected as the research objects.According to the endogenous creatinine clearance rate(Ccr)level,all pregnant women were divided into non-renal injury group(Ccr≥80 mL/min,78 cases)and renal injury group(Ccr<80 mL/min,40 cases).In addition,50 healthy pregnant women were selected as the control group.The levels of urinary microalbumin and urinary creatinine were detected,and UACR were calculated.Urinary RBP levels were detected by latex enhanced immunoturbidimetry.Serum PAPP-A levels were detected by enzyme-linked immunosorbent assay.UACR,urinary RBP and serum PAPP-A levels were compared among the three groups.The linear relationship between UACR,urinary RBP and serum PAPP-A levels and renal injury in GDM was analyzed.The diagnostic efficacy of UACR,urinary RBP and serum PAPP-A for renal injury in GDM were analyzed.Results The levels of UACR and urinary RBP in the renal injury group were higher than those in the non-renal injury group and the control group,and the level of serum PAPP-A was lower than that in the non-renal injury group and the control group,the levels of UACR and urinary RBP in the non-renal injury group were higher than those in the control group,and the level of serum PAPP-A was lower than that in the control group,and the differences were statistically significant(P<0.05).The results of multiple linear regression analysis showed that UACR,urinary RBP and serum PAPP-A were linearly correlated with renal injury in GDM(P<0.05).The sensitivity of UACR,urinary RBP and serum PAPP-A alone and in combination for the diagnosis of renal injury in GDM were 92.50%,85.00%,47.50%and 97.60%respectively,and the specificity w

关 键 词：尿微量清蛋白与尿肌酐比值 视黄醇结合蛋白 妊娠相关血浆蛋白A 妊娠期糖尿病 肾损伤 

分 类 号：R692[医药卫生—泌尿科学]