血清胱抑素C检测在妊娠高血压综合征肾损伤诊断中的临床意义

摘要

Objective To analyze the clinic significance of serum cystatin C testing in diagnosis of renal injury associat-ed with pregnancy-induced hypertension syndrome. Methods Sixty patients,who were diagnosed with pregnancy-induced hy-pertension syndrome in inpatient service and outpatient department in the hospital from January 2012 to December 2013 ,were se-lected as observation group,which was divided into mild group(n=21),moderate group(n=20)and severe group(n=19);simulta-neously another 60 pregnant women undergoing physical examination in the hospital were chose as control group. The concentra-tions of serum cystatin C were detected in all respondents,meanwhile the conventional indexes related to renal function were also inspected;receiver operating characteristic(ROC) curve of the respondents was drawn and analyzed comprehensively. Results Compared with the control group,the levels of serum cystatin C, blood urea nitrogen(BUN) and creatinine(Cr) in the observation group increased significantly,and the difference had statistical significance(P<0.05). The positive detection rate of serum cystatin C of the observation group was more than 90.00%,and the mild group was 90.48%,which pairwise compared with the detection of BUN and Cr(61.90%,66.67%) respectively, the differences both had statistical significance(P<0.05);the pairwise comparisons of serum cystatin C on detection rate with BUN and Cr respectively in moderate group and severe group had no statistically signif-icant difference(P>0.05). The ROC curve analysis demonstrated the diagnostic efficiency of the three indexes for patients with pregnancy-induced hypertension syndrome in follows from high to low were serum cystatin C,Cr and BUN. Conclusion Cystatin C has higher sensitivity and clinical value for early renal damage of the patients with pregnancy-induced hypertension syndrome, which is worthy of clinical promotion.%目的：探讨血清胱抑素C检测在妊娠高血压综合征肾损伤诊断中的临床意义。方法选择2012年1月至2013年12月该院门诊和住院部确诊为妊娠高血压综合征的60例患者为观察组，根据病情程度，分为轻度组（21例）、中度组（20例）和重度组（19例）。另选择同期在该院进行健康体检的孕妇60例为对照组。所有受试人员均进行血清胱抑素C浓度检测，同时检测肾功能相关常规指标（尿素和肌酐）水平，绘制受试者工作特征曲线（ROC曲线），并进行综合分析。结果观察组患者血清胱抑素C、尿素和肌酐水平较对照组显著提升，差异均有统计学意义（P＜0.05）。观察组患者血清胱抑素C阳性检出率在90.00%以上，轻度组患者血清胱抑素C阳性检出率为90.48%，分别与对应的尿素、肌酐阳性检出率（61.90%、66.67%）进行两两比较，差异均有统计学意义（P＜0.05），中、重度组患者血清胱抑素C的阳性检出率分别与对应的尿素、肌酐阳性检出率进行两两比较，差异均无统计学意义（P＞0.05）。ROC曲线分析结果显示，3项指标对于妊娠高血压综合征肾损伤的诊断效率从高到低依次为血清胱抑素C、肌酐、尿素。结论血清胱抑素C对于诊断妊娠高血压综合征患者的早期肾损伤具有较高的灵敏度和临床价值，值得在临床推广应用。