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目的通过检测Lipocalin型前列腺素D合成酶(L-PGDS)、尿微量白蛋白(UmALb),探讨两者在妊娠期高血压疾病早期肾损伤诊断中的价值。方法选取2014年5月-2015年4月该院收治的妊娠期高血压疾病患者95例为妊娠期高血压疾病组,其中妊娠期高血压30例,轻度子痫前期32例,重度子痫前期33例;同期选取该院健康产检孕妇40例为对照组,采用酶联免疫吸附试验检测L-PGDS,免疫透射比浊法检测UmALb,并进行比较分析。结果与对照组比较,妊娠期高血压疾病组L-PGDS水平明显降低,UmALb明显升高,差异有统计学意义(均P<0.01);与妊娠期高血压患者比较,轻度子痫前期患者L-PGDS明显降低,UmALb明显升高,差异均有统计学意义(P<0.05或P<0.01),重度子痫前期患者L-PGDS明显降低(P<0.01),UmALb明显升高(P<0.01);与轻度子痫前期患者比较,重度子痫前期患者L-PGDS明显降低(P<0.05),UmALb明显升高(P<0.01);妊娠期高血压疾病患者L-PGDS与UmALb水平成负相关,(r=-0.625,P<0.01)。结论联合检测尿L-PGDS与UmALb,能发现妊娠期高血压疾病患者早期肾功能的改变,避免发生不可逆的肾损伤,有重要临床意义。
Objective To investigate the value of L-PGDS and UmALb in the diagnosis of early renal damage in hypertensive disorder complicating pregnancy. Methods From May 2014 to April 2015, 95 cases of hypertensive disorder complicating pregnancy were admitted to this hospital. Among them, there were 30 cases of gestational hypertension, 30 cases of gestational hypertension, 32 cases of mild preeclampsia and severe eclampsia In the same period, 40 healthy pregnant women were selected as the control group. L-PGDS was detected by enzyme-linked immunosorbent assay (ELISA) and UmALb by immunoturbidimetric assay. Results Compared with the control group, the levels of L-PGDS in gestational hypertension group were significantly lower and the UmALb levels were significantly higher (all P <0.01). Compared with those in hypertensive disorder complicating pregnancy, the patients with mild preeclampsia (P <0.05 or P <0.01), L-PGDS significantly decreased (P <0.01) and UmALb significantly increased in patients with severe preeclampsia (P < 0.01). Compared with patients with mild preeclampsia, L-PGDS significantly decreased (P <0.05) and UmALb significantly increased in patients with severe preeclampsia (P <0.01). The levels of L-PGDS and UmALb Negatively correlated (r = -0.625, P <0.01). Conclusions Combined detection of urinary L-PGDS and UmALb can find early renal function changes in patients with hypertensive disorder complicating pregnancy and avoid irreversible renal injury, which has important clinical significance.