尿液补体因子D联合血清胱抑素C预测重度子痫前期肾损伤的价值研究

Study on value of urine complement factor D combined with serum cystatin C level in predicting severe renal injury of pre-eclampsia

摘要:

目的 探讨尿液补体因子D联合血清半胱氨酸蛋白酶抑制剂C（简称胱抑素C）水平在预测重度子痫前期肾损伤中的价值。方法 回顾性分析2015年6月—2017年8月西安市第三医院妇产科就诊的260例孕妇的临床资料，根据是否发展为重度子痫前期分为病例组和对照组。以上孕妇在孕中期均进行尿液补体因子D和血清胱抑素C水平的检测，同时收集以上孕妇发生重度子痫前期时肾功能的指标（24?h肌酐清除率），比较两组人群尿液补体因子D、血清胱抑素C水平、24?h肌酐清除率的差异，采用受试者操作特征（ROC）曲线计算尿液补体因子D和血清胱抑素C水平预测肾损伤的曲线下面积（AUC）。结果 260例孕妇中25例发展为重度子痫前期，发生率为9.62%，病例组中患者均出现不同程度的肾损伤。病例组尿液补体因子D、血清胱抑素C水平高于对照组，尿液补体因子D、血清胱抑素C水平能够预测重度子痫前期肾损伤，AUC分别为0.747（95% CI：0.632，0.832）、0.776（95% CI：0.676，0.861），两个指标联合的AUC为0.881（95% CI：0.719，0.932）。结论 尿液补体因子D和血清胱抑素C水平可作为预测重度子痫前期肾损伤的指标，具有一定的临床参考价值，值得在临床推广。

Abstract:

Objective To investigate the value of urine complement factor D combined with serum cystatin C level in predicting severe pre-eclampsia renal injury. Methods The clinical data of 260 pregnant women admitted to the Department of Obstetrics and Gynecology of our hospital from June 2015 to August 2017 were retrospectively analyzed. According to whether they developed into severe pre-eclampsia, they were divided into case group and control group. The above pregnant women all underwent urine complement factor D and serum cystatin C levels at pregnant metaphase during pregnancy. Urine complement factor D and serum cystatin C levels were calculated using the subject's work characteristics curve (ROC) to predict the area under the kidney injury. Results Of the 260 women, 25 developed severe pre-eclampsia with an incidence of 9.62%. The serum complement factor D and Src C levels in the case group were obviously higher than those of control group, the receiver-operating characteristic curve (ROC), according to the results of urine, serum complement factor D [Src C level could predict preeclampsia kidney damage (AUC were 0.747, (95% CI: 0.632, 0.832), 0.776 (95% CI: 0.676, 0.861), and two measures of joint AUC is 0.881, (95% CI: 0.719, 0.932)]. Conclusions Urine complement factor D and serum cystatin C level can be used as indicators to predict severe pre-eclampsia renal injury. It has certain clinical reference value and is worthy of clinical promotion.