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目的探讨子痫前期患者血清胱抑素C水平变化。方法选取2011年5月-2012年12月在广州医学院附属深圳沙井医院产检子痫前期病例50例纳入研究组,同期选择健康孕妇50例作为对照组,所有观察对象于孕20周、孕24周、孕28周、孕30周、孕34周、孕36周产检时记录血压及尿蛋白结果,同时测量外周血清胱抑素C水平。结果①子痫前期组孕20周时血清胱抑素C水平为0.75±0.12mg/L,对照组为0.59±0.33mg/L,,两组间比较P<0.05,差异有统计学意义。此后,随孕周增加,两组病例间血清胱抑素C水平均有上升趋势,且相同孕周相比均有统计学差异(P<0.05)。②子痫前期组孕28周时收缩压为145.2±19.1mmHg,舒张压为89.5±15.7mmHg,对照组孕28周时收缩压为133.1±17.2mmHg,舒张压为80.4±17.3mmHg,此后随孕周增加,两组病例收缩压及舒张压均呈进行性上升,且相同孕周相比具有统计学差异(P<0.05)。孕20周、孕24周时子痫前期组及对照组相比,舒张压及收缩压无统计学差异(P>0.05)。③子痫前期组首次出现尿蛋白时间为1例28周,10例30周,21例34周,18例36周,对照组没有尿蛋白。结论子痫前期患者孕20周后胱抑素C升高,早于临床血压及尿蛋白改变时间,胱抑素C可能是子痫前期发生预测及肾功能早期损害的敏感指标。
Objective To investigate the changes of serum cystatin C in patients with preeclampsia. Methods From May 2011 to December 2012, 50 cases of preeclampsia in Shenzhen Manhole Hospital affiliated to Guangzhou Medical College were enrolled in the study group. Fifty healthy pregnant women were selected as the control group in the same period. All the subjects were enrolled in the study. Weeks, 28 weeks of pregnancy, 30 weeks of pregnancy, 34 weeks of pregnancy, 36 weeks of pregnancy check-up records of blood pressure and urinary protein results, while measuring serum levels of cystatin C. Results ① The level of serum cystatin C was 0.75 ± 0.12 mg / L at 20 weeks of preeclampsia and 0.59 ± 0.33 mg / L in control group, P <0.05 was significant difference between the two groups. Since then, with the increase of gestational age, serum cystatin C levels increased in both groups, and the same gestational weeks were statistically significant (P <0.05). ②The pre-eclampsia group had a systolic blood pressure of 145.2 ± 19.1mmHg and a diastolic pressure of 89.5 ± 15.7mmHg at 28 weeks of gestation. The control group had systolic blood pressure of 133.1 ± 17.2mmHg and diastolic blood pressure of 80.4 ± 17.3mmHg at 28 weeks of gestation, Systolic blood pressure and diastolic blood pressure increased progressively in both groups with statistical significance (P <0.05) in the same gestational age. Compared with preeclampsia group and control group, there was no significant difference in diastolic blood pressure and systolic blood pressure between the first trimester of pregnancy and the second trimester of pregnancy (P <0.05). ③ The first time urine protein in preeclampsia group was 28 cases in one case, 10 cases in 30 weeks, 21 cases in 34 weeks and 18 cases in 36 weeks. The control group had no urinary protein. Conclusions Cystatin C is elevated in preeclampsia patients 20 weeks after pregnancy, earlier than clinical blood pressure and urinary protein change time. Cystatin C may be a sensitive index for predicting preeclampsia and early renal damage.