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目的比较随机尿白蛋白/肌酐(A/Cr)和点时间尿蛋白/肌酐(P/Cr)在子痫前期的应用价值,明确替代24 h尿蛋白定量(UPRO)最佳方法。方法选取2013年5月-2015年5月在本院收治的轻度子痫前期孕妇36例,重度子痫前期孕妇28例,正常孕妇25例;根据UPRO数值分为3组:0.3 g~5 g、>5g、总体,对A/Cr、P/Cr和UPRO进行各自相关性分析。采取ROC曲线分析确定A/Cr和P/Cr相对于UPRO为0.3 g及5 g的诊断界点。结果 A/Cr和P/Cr与24 h尿蛋白0.3 g~5 g呈正相关(r值分别为0.676、0.630,P<0.01)。A/Cr与24 h尿蛋白>5 g无相关性(r=0.285,P>0.05);P/Cr与24 h尿蛋白>5 g呈正相关(r=0.699,P<0.01),P/Cr与24 h尿蛋白>5 g相关性优于A/Cr。UPRO≥0.3 g,A/Cr和P/Cr曲线下面积分别为0.966和0.960;UPRO≥5 g,A/Cr和P/Cr曲线下面积分别为0.856和0.915。结论点时间P/C在子痫前期应用价值优于随机尿A/Cr,更能全面、准确替代UPRO,是子痫前期诊断和病情监测中简单、可靠的方法。
Objective To compare the value of urinary albumin / creatinine (A / Cr) and point-time urinary protein / creatinine (P / Cr) in preeclampsia and to identify the best alternative to UPRO. Methods Totally 36 pregnant women with mild preeclampsia, 28 pregnant women with severe preeclampsia and 25 normal pregnant women were enrolled in our hospital from May 2013 to May 2015. The patients were divided into 3 groups according to the UPRO value: 0.3 g ~ 5 g,> 5g, overall, the A / Cr, P / Cr and UPRO were analyzed for their correlation. The ROC curve analysis was used to determine the diagnostic boundaries for A / Cr and P / Cr relative to UPRO of 0.3 g and 5 g. Results A / Cr and P / Cr were positively correlated with 24 h urinary protein 0.3 g ~ 5 g (r = 0.676,0.630, P <0.01). P / Cr was positively correlated with 24 h proteinuria> 5 g (r = 0.699, P <0.01), P / Cr Correlation with 24 h urine protein> 5 g was better than A / Cr. UPRO≥0.3 g, the areas under the A / Cr and P / Cr curves were 0.966 and 0.960, respectively. The areas under UPRO≥5 g, A / Cr and P / Cr curves were 0.856 and 0.915, respectively. Conclusion The application of P / C in preeclampsia is superior to random urine A / Cr in point time, which can replace UPRO completely and accurately. It is a simple and reliable method for the diagnosis and condition monitoring of preeclampsia.