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目的探讨血清胱抑素C(Cys-C)、同型半胱氨酸(Hcy)在妊娠期高血压综合征患者中的变化及早期肾损伤中的价值。方法选择待产分娩的单胎妊娠孕妇为研究对象,其中重度子痫前期70例(重度PE组),轻度子痫前期60例(轻度PE组),妊娠期高血压70例(妊娠高血压组)及正常足月待产孕妇100例(对照组)。采用免疫比浊法测定血清Cys-C,循环酶法测定血清Hcy,计算肾小球率过滤(GFR),分析Cys-C、Hcy水平与GFR的关系。结果重度PE组、轻度PE组、妊娠高血压组Cys-C、Hcy高于对照组,而GFR低于对照组(P<0.05),且随妊娠期高血压疾病病情加重,Cys-C及Hcy水平呈上升趋势。Cys-C、Hcy水平与GFR呈负相关(r=-0.336、-0.438,P<0.05)。以Cys-C、Hcy联合检测妊娠期高血压综合征早期肾损伤的曲线下面积大于Cys-C、Hcy单项检测(P<0.05)。结论妊娠期高血压综合征患者血清Cys-C、Hcy水平升高,并且随着病情的加重而升高明显;联合检测血清Cys-C、Hcy对早期肾损伤有更高的预测价值。
Objective To investigate the changes of serum cystatin C (Cys-C) and homocysteine (Hcy) in patients with pregnancy-induced hypertension and the value of early renal injury. Methods The singleton pregnant women who were to be given birth were selected as research object, including 70 cases of severe preeclampsia (severe PE group), 60 cases of mild preeclampsia (mild PE group), 70 cases of gestational hypertension (pregnancy-induced hypertension Group) and 100 normal term pregnant women (control group). Serum Cys-C levels were measured by immunoturbidimetry, serum Hcy was measured by enzymatic cycling, glomerular filtration rate (GFR) was calculated, and the relationship between Cys-C, Hcy levels and GFR was analyzed. Results The levels of Cys-C and Hcy in severe PE group, mild PE group and gestational hypertension group were higher than those in control group, while GFR was lower than that in control group (P <0.05). With the increase of hypertensive disorder complicating pregnancy, Cys-C and Hcy levels are on the rise. The levels of Cys-C and Hcy were negatively correlated with GFR (r = -0.336, -0.438, P <0.05). Cys-C, Hcy combined detection of pregnancy-induced hypertension in early renal damage area under the curve greater than Cys-C, Hcy single test (P <0.05). Conclusions The serum levels of Cys-C and Hcy in patients with pregnancy-induced hypertension are elevated and increased with the severity of the disease. Combined detection of serum Cys-C and Hcy has a higher predictive value for early renal injury.