随机尿微量白蛋白/肌酐比值在子痫前期中的诊断价值

摘要

目的:通过分析子痫前期孕妇随机尿微量白蛋白/肌酐比值(UACR)与24 h尿蛋白定量的相关性,探讨随机尿微量白蛋白/肌酐比值在子痫前期中的诊断价值.方法:选择2015年08月至2016年10月,首都医科大学附属北京安贞医院收治的子痫前期孕妇100例(轻度30例,重度70例),随机抽取100例正常单胎孕妇作为对照.检测孕妇随机尿微量白蛋白/肌酐比值(UACR)及24 h尿蛋白定量,并进行二者的相关性分析;应用受试者工作特征曲线(ROC)得出轻度和重度子痫前期孕妇的尿微量白蛋白/肌酐比值的最佳诊断值.结果:①正常孕妇与子痫前期孕妇及轻、重度子痫前期孕妇比较,随机尿微量白蛋白/肌酐比值及24 h尿蛋白定量差异均有统计学意义(P＜0.05).②轻、重度子痫前期孕妇尿白蛋白/肌酐比值与24 h尿蛋白定量均有高度相关性(r分别为0.799、0.833,P均＜0.05).③尿微量白蛋白/肌酐比值用于诊断子痫前期轻、重度的最佳值分别为16.32mg/mmol及63.89mg/mmol.结论:UACR与子痫前期的严重程度及24 h尿蛋白定量均有高度相关性,可用于判断子痫前期病情严重程度.%Objective:To investigate the correlation between spot urine microalbumin to creatinine ratio (UACR) and 24 hours urinary protein excretion in women with preeclampsia and the diagnostic value of random spot UACR in women with hypertensive disorders complicating pregnancy-preeclampsia.Methods:A total of 100 women with preeclampsia (30 with mild preeclampsia and 70 with severe preeclampsia) and 100 women taken as the control group at Beijing Anzhen Hospital,Capital Medical University between August 2015 and October 2016 were recruited.Random spot urine microalbumin to creatinine ratio (UACR) and 24 hours urinary protein excretion were collected and analyzed.Bivariate correlation was used to analyze the relationship between UACR and 24 hours urinary protein excretion.And the optimal cut-off values of the UACR for mild and severe preeclampsia were determined with receiver operating characteristic curve.Results:① The differences in random spot urine microalbumin to creatinine ratio(UACR) and 24 hours urinary protein excretion between normal and preeclampsia,and mild and severe preeclampsia were respectively statistically significant (P ＜ 0.05).② There was a strong correlation between the UACR and 24 hours urine protein excretion in mild and severe preeclampsia (r =0.799,0.833;P ＜ 0.05).③The optimal UACR cut-off point for the diagnosis of mild and severe preeclampsia were 16.32mg/mmol,63.89mg/mmol separately.Conclusion:There is positive correlation between UACR and 24 hours urinary protein.UACR can be used for estimating the severity degree of preeclampsia.