尿免疫球蛋白、转铁蛋白、微量白蛋白及β2－微球蛋白的联合检测对妊娠期高血压疾病的临床价值

摘要

目的：探讨尿免疫球蛋白（ IgG）、转铁蛋白（ TRF）、微量白蛋白（ mALB）、β2－微球蛋白（β2－MG）的联合检测对妊娠期高血压疾病的临床价值。方法免疫比浊法检测73例妊娠期高血压疾病患者尿IgG、TRF、mAlb、β2－MG的水平，其中重度子痫前期患者29例（Ⅰ组），轻度子痫前期患者20例（Ⅱ组）及妊娠期高血压患者24例（Ⅲ组），并与30例正常妊娠妇女（Ⅳ组）的检测结果进行比较。结果Ⅰ组患者的尿IgG[（121．86±68．57）mg／L]、TRF[（123．65±52．68）mg／L]、mALB [（509．55±214．83）mg／L]均显著高于其他各组，差异有统计学意义（P＜0．01）；Ⅰ组患者的尿β2－MG[（1144．29±1010．28）μg／L]高于Ⅲ组和Ⅳ组患者，差异有统计学意义（P＜0．05）；Ⅱ组患者的IgG[（42．05±17．45）mg／L]、TRF[（28．51±9．16）mg／L]、mALB[（103．2±33．05）mg／L]高于Ⅲ组和Ⅳ组，差异有统计学意义（P＜0．05）。Ⅱ组患者的尿β2－MG与其他各组比较差异无统计学意义（P＞0．05），4项指标在Ⅲ组和Ⅳ组患者之间的差异无统计学意义（P＞0．05）。Ⅰ、Ⅱ组患者的4项指标异常率高于Ⅲ组和Ⅳ组，差异有统计学意义（ P＜0．05）。结论随着妊娠期高血压疾病病情加重，尿IgG、TRF、mAlb、β2－MG的排泄量逐渐升高，且随着病情加重，可出现多种尿蛋白的同时升高。联合检测尿IgG、TRF、mAlb、β2－MG对判断妊娠期高血压疾病的严重程度有一定的临床价值。%Objective To investigate the clinic significance of urinary immunoglobulin G (IgG), transferring (TRF), mi-croalbumin ( mALB) ,β2-microglobulin (β2-MG) in the diagnosis of hypertensive disorders during pregnancy .Methods Immunotur-bidimetry was used to detect urinary IgG , TRF, mALB andβ2-MG in 73 patients with hypertensive disorders complicated with pregnan-cy.Of the 73 patients, 29 with severe preeclampsia were designated as group I , 20 with mild preeclampsia were designated as group Ⅱand 24 patients with gestational hypertension were designated as group Ⅲ.Another 30 healthy pregnant women were selected as the con-trol group (groupⅣ).Results The levels of urinary IgG[(121.86 ±68.57)mg/L], TRF[(123.65 ±52.68)mg/L], mALB[(509.55 ±214.83)mg/L] in the patients of groupⅠwere significantly higher than those of the other 3 groups(P<0.01).The level of urinaryβ2-MG[(1 144.29 ±1 010.28)μg/L] of the patients in group Ⅰwas higher than those of the patients in groups Ⅲand groupⅣ, with statistical significance(P<0.05).The levels of urinary IgG [(42.05 ±17.45) mg/L], TRF[(28.51 ±9.16) mg/L] and mALB [(103.27 ±33.05)mg/L] in the patients of group II were higher than those of groups Ⅲ and group Ⅳ, with statistical significance (P<0.05).There was no statistical significance in the level of urinary β2-MG for the patients of group II, when comparisons were made with the other 3 groups(P>0.05).There were no significant differences in the 4 indicators, when comparisons were made be-tween groupⅢand groupⅣ(P>0.05).Abnormal rates of the 4 indicators in the patients of groups ⅠandⅡwere significantly higher than those of groups Ⅲand Ⅳ(P<0.05).Conclusion With the deterioration of hypertensive disorder during pregnancy , the excre-tion of urinary IgG , TRF, mALB andβ2-MG gradually increased and simultaneously there was an increase of a variety of urine proteins . Combined measurement of urinary IgG , TRF, mALB andβ2-MG has clinical value for the assessment of the severity of hypertensive dis-order during pregnancy .