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目的:进行妊娠期高血压疾病与尿微量白蛋白和血清胱抑素的关系研究。方法:取空腹妊娠高血压疾病孕妇静脉血3 ml进行生化分析仪测定。观察各组孕妇的血清胱抑素C、同型半胱氨酸(hCY)及人绒毛膜促性腺激素(hCG)水平,尿酸、尿素氨、肌酐值;孕妇尿微量白蛋白水平和妊娠结局。结果:观察组孕妇血清胱抑素C[(1.31±0.41)mg/L],hCY[(20.3±7.6)μmol/L]和hCG[(20.1±7.5)IU/ml]水平均高于对照组[(0.81±0.25)mg/L,(7.1±1.3)μmol/L,(10.2±2.0)IU/ml],两组比较,差异有统计学意义(P<0.05)。观察组孕妇尿酸[(372.6±98.3)μmol/L]、尿素氨[(5.37±0.94)mmol/L]和肌酐[(80.3±12.5)μmol/L]水平均高于对照组[(275.2±81.6)μmol/L,(4.31±0.83)mmol/L,(67.4±10.2)μmol/L],两组比较,差异有统计学意义(P<0.05)。不同程度妊娠期高血压疾病孕妇血清胱抑素C、hCY及hCG水平比较,重度高于中度和轻度,各组间比较,差异有统计学意义(P<0.05)。妊娠期高血压疾病各组孕妇尿微量白蛋白水平明显高于对照组,且随病情的严重程度增加。结论:联合检测血清胱抑素C、hCY及hCG水平、尿酸、尿素氨、肌酐值对预测妊娠期高血压疾病有较高的敏感度和特异度,对判断妊娠期高血压疾病孕妇肾功能损伤及严重程度也具有重要临床意义。
Objective: To study the relationship between gestational hypertension and urinary albumin and serum cystatin. Methods: Blood samples of pregnant women with fasting pregnancy-induced hypertension were measured by biochemical analyzer. Serum levels of cystatin C, homocysteine (hCY) and human chorionic gonadotropin (hCG), uric acid, urea ammonia, creatinine, pregnant women urine microalbumin level and pregnancy outcome were observed. Results: The levels of serum cystatin C (1.31 ± 0.41 mg / L), hCY (20.3 ± 7.6) μmol / L and hCG (20.1 ± 7.5) IU / ml in the observation group were higher than those in the control group (0.81 ± 0.25) mg / L, (7.1 ± 1.3) μmol / L and (10.2 ± 2.0) IU / ml respectively). There was significant difference between the two groups (P <0.05). The levels of uric acid and creatinine in the observation group were significantly higher than those in the control group [(372.6 ± 98.3) μmol / L and [(5.37 ± 0.94) mmol / L and (4.31 ± 0.83) mmol / L and (67.4 ± 10.2) μmol / L, respectively). There was significant difference between the two groups (P <0.05). The levels of serum cystatin C, hCY and hCG in pregnant women with different stages of hypertensive disorder complicating pregnancy were significantly higher than those in moderate and mild cases, and the differences among the groups were statistically significant (P <0.05). The levels of urinary albumin in pregnant women with gestational hypertension were significantly higher than those in the control group, and increased with the severity of the disease. Conclusions: Combined detection of serum cystatin C, hCY and hCG levels, uric acid, urea ammonia and creatinine values have high sensitivity and specificity for predicting hypertensive disorder complicating pregnancy. It is of great value in judging renal dysfunction of pregnant women with hypertensive disorder complicating pregnancy And the severity also has important clinical significance.