Objective:To investigate the value of urinary microalbumin (mALB) level in the diagnosis of postpartum acute renal injury.Methods:The data of 127 women with normal delivery in our hospital from December 2013 to January 2016 were collected.The women were divided to postpartum acute renal injury group (n=31) and normal group (n=96).The levels of creatinine (Cr),urea nitrogen (BUN),glomerular filtration rate (GFR),mALB,and mean arterial pressure (MAP) were measured and compared before and after delivery between the two groups.Results:The MAP,Cr,BUN,GFR and mALB after delivery were significantly higher than before delivery in postpartum acute renal injury group (P＜0.05).The value of mALB/GFR in postpartum acute renal injury group [(0.29 ± 0.15)] was significantly lower than that in normal group [(0.72 ± 0.17)] (P＜0.05).Multivariate logistic regression analysis showed that mALB/GFR,Cr and mALB were independent risk factors for postpartum acute renal injury (P＜0.05).Receiver operating characteristic curve (ROC) analysis showed that the area under the curve of mALB (0.79) was significantly higher than that of Cr (0.68) and mALB/GFR (0.76) (P＜0.05).Conclusions:Urinary microalbumin as a non-invasive index has a high value in the diagnosis of postpartum renal injury,but its specific mechanism,sensitivity and so on still need further investigation.%目的 探讨尿微量白蛋白(mALB)在产后急性肾损伤诊断中的临床意义及应用价值. 方法 收集2013年12月至2016年1月,在我院产科正常分娩的127例产妇为研究对象,将出现产后急性肾损伤的31例产妇作为肾损伤组,其他未出现产后急性肾损伤、一般情况良好的96例产妇为正常组.比较两组产妇分娩前后外周血肌酐(Cr)、尿素氮(BUN)、肾小球滤过率(GFR)、mALB、外周平均动脉压(MAP)等生化指标的差异. 结果 肾损伤组产妇产后的MAP、Cr、BUN、GFR和mALB均显著高于产前和正常组产妇产后水平(P＜0.05).肾损伤组产妇产后的mALB/GFR水平[(0.29±0.15)]显著低于正常组产后水平[(0.72±0.17)](P＜0.05).Logisitic多因素回归分析显示:mALB/GFR、Cr和mALB为产后急性肾损伤的独立危险因素(P＜0.05).ROC曲线分析显示,mALB的曲线下面积(0.79)显著高于Cr和mALB/GFR的曲线下面积(0.68和0.76)(P＜0.05). 结论 mALB作为一种无创检测指标,可能在产后急性肾损伤的诊断中具有较高价值.但其具体机制、敏感性等尚需后期进一步研究探讨.
展开▼
