血清sLOX-1，BTP和尿Kim-1水平对妊娠高血压早期肾损伤的诊断价值

摘要/Abstract

摘要： 目的：观察血清可溶性凝集素样氧化型低密度脂蛋白受体-1（sLOX-1），β-痕迹蛋白（BTP）和尿肾损伤分子-1（Kim-1）水平对妊娠高血压早期肾损伤的诊断价值。方法：选择2016年1月至2018年6月在我院就诊的妊娠高血压患者121例，为妊娠高血压组。选择同期在我院行健康体检的正常妊娠30例，为对照组。比较两组血清sLOX-1，BTP和尿Kim-1水平，分析妊娠高血压患者血清sLOX-1，BTP和尿Kim-1水平与妊娠高血压严重程度和肾功能损伤的关系，在诊断肾功能损伤方面的灵敏度和特异性及各指标之间的相关性。结果：妊娠高血压组患者血清sLOX-1，BTP和尿Kim-1水平均高于对照组（P<0.01）。随着妊娠高血压严重程度的升高，血清sLOX-1，BTP和尿Kim-1水平均升高（P<0.01）。肾功能损伤组妊娠高血压患者血清sLOX-1，BTP和尿Kim-1水平高于肾功能正常组（P<0.01）。妊娠高血压患者血清sLOX-1（r=0.685，P<0.01），BTP（r=0.723，P<0.01）水平与尿Kim-1水平呈正相关，而血清sLOX-1与BTP（r=0.831，P<0.01）水平之间呈正相关。在诊断肾功能损害方面，联合检测的最佳截断值为>0.860，其灵敏度为95.9%，特异性为93.3%，其AUC为0.984，联合检测的曲线下面积优于sLOX-1（Z=3.958，P<0.01），BTP（Z=3.570，P<0.01）和尿Kim-1（Z=4.059，P<0.01），而血清sLOX-1，BTP和尿Kim-1的曲线下面积之间的比较差异无统计学意义（P>0.05）。结论：血清sLOX-1，BTP和尿Kim-1是妊娠高血压疾病的重要生物学指标，对诊断妊娠高血压早期肾损伤均具有重要意义，联合检测有助于提高诊断早期肾功能损伤的灵敏度和特异性。

Abstract: Objective： To observe the value of serum soluble lectin-like oxidized low density lipoprotein receptor-1 (sLOX-1)， β-trace protein (BTP) and urinary kidney injury molecule-1 (Kim-1) levels in diagnosis of early renal damage of gestational hypertension. Methods： 121 patients with gestational hypertension who were admitted in our hospital from January 2016 to June 2018 were enrolled as gestational hypertension group. 30 normal pregnant women who had physical examination in our hospital at the same period were selected as the control group. The levels of serum sLOX-1， BTP and urinary Kim-1 were detected in the gestational hypertensive group and the control group. The relation among the levels of serum sLOX-1， BTP and urinary Kim-1 in patients with gestational hypertension， the severity of gestational hypertension and renal function damage were analyzed. The sensitivity and specificity of those in diagnosing renal impairment and correlation analysis between each indicators were valued in patients with gestational hypertension. Results： The serum sLOX-1， BTP and urinary Kim-1 levels in the gestational hypertension group were higher than those in the control group (P<0.01)， and were increased with the increase of the severing of gestational hypertension (P<0.01). The serum sLOX-1， BTP and urinary Kim-1 levels in patients of gestational hypertension with renal function damage group were higher than those in normal renal function group (P<0.01). The serum levels of sLOX-1 (r=0.685， P<0.01) and BTP (r=0.723， P<0.01) were positively correlated with urinary Kim-1 levels in patients with gestational hypertension， and the serum levels of sLOX-1 were positively correlated with the levels of BTP (r=0.831， P<0.01). In the diagnosis of renal damage， the optimal cut-off value of combination detection was >0.860， the sensitivity was 95.9%， the specificity was 93.3%， and the area under the curve was 0.984， which is better than sLOX-1(Z=3.958， P<0.01)， BTP (Z=3.570， P<0.01) and Kim-1 (Z=4.059， P<0.01)， and the comparison of the areas under the curve among serum sLOX-1， BTP and urine Kim-1 had no statistically significant difference (P>0.05). Conclusion： The serum sLOX-1， BTP and urinary Kim-1 are important biological indicators in patients with gestational hypertension. It is of great significance in the diagnosis of early renal injury in gestational hypertension. Combination detection can help to improve the sensitivity and specificity in the diagnosis of early renal impairment.

吴海湉,郭雪晶,沈丽华. 血清sLOX-1，BTP和尿Kim-1水平对妊娠高血压早期肾损伤的诊断价值[J]. .

WU Haitian,GUO Xuejing and SHEN Lihua. Diagnostic Value of Serum sLOX-1， BTP and Urinary Kim-1 Levels in Early Renal Injury Induced by Gestational Hypertension[J]. .

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