摘要
目的研究检测血清胱抑素C(CysC)、尿液肾损伤分子-1(KIM-1)水平在评估妊娠期高血压疾病(HDP)患者肾小管间质损伤程度的意义。方法选取2021年1月至2021年12月在常州市妇幼保健院就诊的74例有肾小管间质损伤的HDP患者为肾损伤组,86例无肾小管间质损伤的HDP患者为非肾损伤组,另选取常规体检孕妇80例作为健康对照组。于孕22~26周比较三组的CysC水平、KIM-1水平。采用Cox回归分析肾小管间质损伤程度的影响因素,采用受试者工作特征曲线(ROC)评估CysC、KIM-1指标的预测价值。结果肾损伤组CysC水平、KIM-1水平高于非肾损伤组和健康对照组,非肾损伤组高于健康对照组(F值分别为84.712、516.732,P<0.05);肾损伤组内重度29例,轻度45例;重度患者CysC水平、KIM-1水平高于轻度患者(t值分别为5.301、5.706,P<0.05);经Cox回归分析显示CysC水平、KIM-1水平是肾小管间质损伤程度的独立影响因素,其OR值及95%CI分别为7.412(3.547~11.236)、7.215(2.842~13.985),P<0.05;经ROC分析显示,CysC、KIM-1评估HDP患者肾小管间质损伤程度的截断值分别为1.57mg/L、6.08ng/mL,ROC曲线下面积(AUC)分别为0.844、0.783,且两指标均具有较好的灵敏度和特异度。结论血清CysC、尿液KIM-1在诊断HDP患者的肾小管间质损伤程度中有着重要价值,能为临床评估患者病情和制定后续治疗方案提供参考依据。
Objective To explore the value of serum cystatin C(CysC)and urine kidney injury molecule-1(KIM-1)in evaluating the degree of renal tubule-interstitial injury in patients with hypertensive disorders of pregnancy(HDP).Methods From January 2021 to December 2021,74 cases of HDP patients with renal tubule-interstitial injury in Changzhou Maternal and Child Health Care Hospital were selected as the renal injury group,86 cases of HDP patients without renal tubule-interstitial injury were selected as the non-renal injury group,and 80 pregnant women with routine physical examination were selected as the healthy control group.At 22 to 26 weeks of gestation,the levels of CysC and KIM-1 were compared among the three groups.The influencing factors of the degree of renal tubule-interstitial injury were analyzed by Cox regression.The predictive values of CysC and KIM-1 were analyzed by receiver operating characteristic(ROC)curve.Results The levels of CysC and KIM-1 in the renal injury group were higher than those in the non-renal injury group and the healthy control group,and the levels of CysC and KIM-1 in the non-renal injury group were higher than those in the healthy control group(F=84.712 and 516.732,respectively,P<0.05).In the renal injury group,29 cases were severe and 45 cases were mild.The levels of CysC and KIM-1 in patients with severe tubule-interstitial injury were higher than those in patients with mild tubule-interstitial injury(t=5.301 and 5.706,respectively,P<0.05).Cox regression analysis showed that the levels of CysC and KIM-1 were the independent factors affecting the degree of renal tubule-interstitial injury,and the OR values and 95%CI were 7.412(3.547-11.236)and 7.215(2.842-13.985),respectively,P<0.05.ROC analysis showed that the cut off values of CysC and KIM-1 in evaluating the degree of renal tubule-interstitial injury in HDP patients were 1.57mg/L and 6.08ng/mL,respectively,and area under the curve(AUC)were 0.844 and 0.783,respectively.The two indexes had good sensitivity and specificity.Conclusion Serum CysC and urine KIM-1 have important values in diagnosing the degree of renal tubule-interstitial injury in HDP patients for which they provide important reference for the clinical assessment on the patients′state of illness and the fabrication of future treatment method.
作者
于运
张铭
王俊
YU Yun;ZHANG Ming;WANG Jun(Department of Clinical Laboratory,Changzhou Maternal and Child Health Care Hospital,Jiangsu Changzhou 213000,China)
出处
《中国妇幼健康研究》
2023年第2期34-39,共6页
Chinese Journal of Woman and Child Health Research
基金
江苏省“第五期333工程”科研项目(BRA2019160)
南京医科大学科技发展基金(NMUB2020076)。
关键词
妊娠期高血压疾病
肾小管间质损伤程度
血清胱抑素C
尿液肾损伤分子-1
hypertensive disorders of pregnancy
degree of renal tubule-interstitial injury
serum cystatin C
kidney injury molecule-1
