NLR，β-HCG和Cys C在早期诊断妊娠高血压肾损伤的价值

摘要/Abstract

摘要： 目的：观察中性粒细胞-淋巴细胞比率（NLR）、人绒毛膜促性腺激素（β-HCG）和胱抑素C（Cys C）在妊娠期高血压（HDCP）肾损伤中的早期诊断价值。方法：选择2017年1月至2018年12月在我院就诊的HDCP患者125例，为HDCP组。根据HDCP严重程度将患者分为轻度43例、中度46例和重度36例。选择同期在我院正常妊娠的孕妇75例，为正常妊娠组。采用酶联免疫吸附法测定血清β-HCG、Cys C和β2-微球蛋白（β2-MG）水平。比较NLR、β-HCG、Cys C和β2-MG水平在HDCP组和正常妊娠组变化，与HDCP严重程度、肾功能损害和肾功能损害分期的关系，评价以上指标在诊断HDCP肾功能损害的价值。结果：HDCP组患者NLR、β-HCG、Cys C和β2-MG水平均高于正常妊娠组（P<0.01）。NLR、β-HCG、Cys C和β2-MG水平随着HDCP严重程度升高而升高。HDCP肾功能异常组NLR、β-HCG、Cys C和β2-MG水平均高于肾功能正常组（P<0.01），并且随着肾功能异常分期升高而升高（P<0.01）。在诊断HDCP患者肾功能损害方面，NLR（Z=2.890，P<0.01）、β-HCG（Z=4.177，P<0.01）和Cys C（Z=3.057，P<0.01）的诊断价值优于β2-MG，NLR、β-HCG、Cys C之间比较差异无统计学意义（P>0.05）。联合检测（NLR +β-HCG + Cys C）灵敏度为95.7%，特异性为91.0%，曲线下面积为0.985，明显优于单个指标NLR（Z=4.215，P<0.01）、β-HCG（Z=3.283，P<0.01）和Cys C（Z=3.984，P<0.01）的诊断效能。结论：NLR，β-HCG和Cys C在早期诊断HDCP肾损伤具有明显的临床应用价值，联合检测优于单个指标的诊断价值，为早期HDCP肾功能损害的干预提供了依据。

关键词: 妊娠高血压, 肾损害, 人绒毛膜促性腺激素, 中性粒细胞, 淋巴细胞

Abstract: ]Objective： To observe the early diagnostic efficacy of neutrophil-lymphocyte ratio (NLR)， human chorionic gonadotropin (β-HCG) and cystatin C (Cys C) for early renal impairment of patients with hypertensive disorder complicating pregnancy (HDCP). Methods： 125 patients with HDCP who were admitted in our hospital from January 2017 to December 2018 were enrolled in HDCP group， and were divided into mild 43 cases， moderate 46 cases and severe 36 cases according to the severity of HDCP. 75 pregnant women with normal pregnancy in our hospital were selected as normal pregnancy group. The serum levels of β-HCG， Cys C and β2-MG were determined by enzyme-linked immunosorbent assay. The NLR， β-HCG， Cys C and β2-MG levels in HDCP group were compared with normal pregnancy group. And the relation with the HDCP severity， renal dysfunction and renal dysfunction stage， and their efficacy in diagnosing HDCP renal dysfunction were compared. Results： The levels of NLR， β-HCG， Cys C and β2-MG in HDCP group were significantly higher than those in normal pregnancy group (P<0.01). The levels of NLR， β-HCG， Cys C and β2-MG increased with the severity of HDCP. The levels of NLR， β-HCG， Cys C and β2-MG in HDCP renal dysfunction group were higher than those in HDCP normal renal function group (P<0.01)， and increased as the renal function stage increased (P<0.01). Diagnostic efficacy of NLR (Z=2.890， P<0.01)， β-HCG (Z=4.177， P<0.01) and Cys C (Z=3.057， P<0.01) in the diagnosis of renal dysfunction in HDCP was better than β2-MG， and there was no significant difference among NLR， β-HCG， Cys C (P>0.05). The combined detection (NLR+β-HCG+ Cys C) has a sensitivity of 95.7% and a specificity of 91.0%. The area under the curve is 0.985， which is significantly better than the single index NLR (Z=4.215， P<0.01)， β-HCG (Z=3.283， P<0.01) and Cys C (Z=3.984， P<0.01). Conclusion： NLR， β-HCG and Cys C have high efficacy in early diagnosis of early renal impairment of patients with HDCP. The combined detection is superior to the detection of single maker， which provides theoretical basis for the intervention of early renal dysfunction patients with HDCP.

Key words: Gestational hypertension, Renal damage, Human chorionic gonadotropin, Neutrophils, Lymphocytes

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李婷婷毛丽萍. NLR，β-HCG和Cys C在早期诊断妊娠高血压肾损伤的价值[J]. 中国医药导刊, 2019, 21(11): 0-0.

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NLR，β-HCG和Cys C在早期诊断妊娠高血压肾损伤的价值

Diagnosis Value of NLR， β-HCG and Cys C for Early Renal Impairment of Patients with Hypertensive Disorder Complicating Pregnancy

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