尿L-FABP与ACR联合检测在妊娠期高血压综合征早期肾损伤中的诊断价值
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摘要
目的探讨随机尿肝型脂肪酸结合蛋白(L-FABP)联合尿清蛋白与尿肌酐比值(ACR)检测在妊娠期高血压综合征(PHS)早期肾损伤中的诊断价值。方法筛选该院妇产科门诊就诊和住院孕妇220例,其中正常妊娠无高血压80例(A组),妊娠期高血压无蛋白尿80例(B组),妊娠期高血压伴蛋白尿60例(C组)。采用酶联免疫吸附测定(ELISA)检测尿L-FABP,生化法检测血肌酐、血胱抑素C及随机尿ACR,比较3组孕妇随机尿L-FABP与ACR的相关性。结果 C组尿L-FABP与ACR水平高于B组[(45.55±4.2)μg·g~(-1)·Cr~(-1) vs.(5.53±0.55)μg·g~(-1)·Cr~(-1);(146.3±22.6)mg·-1·Cr~(-1) vs.(8.85±1.52)mg·g~(-1)·Cr~(-1)],差异有统计学意义(P<0.05),B组与A组尿L-FABP与ACR水平比较,差异无统计学意义(P>0.05)。C组尿L-FABP与ACR水平有显著的相关性(r=0.802,P<0.05)。结论随机尿L-FABP可作为PHS早期肾损伤诊断的敏感标志物,联合尿L-FABP和ACR检测可提高PHS早期肾损伤诊断灵敏度。
Objective To study the diagnostic value of combined detection of urinary liver type fatty acid binding protein(L-FABP)and albumin creatinine ratio(ACR)in early renal injury in pregnancy induced hypertension syndrome(PHS).Methods A total of 220 gravidas were divided into three groups:pregnancy without hypertension(group A),pregnancy with hypertension and without proteinuria(group B),and pregnancy with hypertension and proteinuria(group C).L-FABP in random urine was analyzed by enzyme linked immunosorbent assay(ELISA).ACR in random urine,plasma cystatin C and plasma creatinine were measured by biochemical process.Results Urinary L-FABP and ACR in group C were significantly higher than those in group B [(45.55±4.2)μg·g~(-1)·Cr~(-1) vs.(5.53±0.55)μg·g~(-1)·Cr~(-1);(146.3±22.6)mg·g~(-1)·Cr~(-1) vs.(8.85±1.52)mg·g~(-1)·Cr~(-1))](P<0.05),and no differences between group A and group B(P>0.05).There was a correlation between the levels of urinary L-FABP and ACR in group C(r=0.802,P<0.05).Conclusion L-FABP in random urine is a sensitive marker in diagnosis of early renal injury in pregnancy-induced hypertension syndrom.Combined detection of urinary L-FABP and ACR can improve the diagnostic sensitivity of early renal injury in patients with pregnancy-induced hypertension syndrom.
Objective To study the diagnostic value of combined detection of urinary liver type fatty acid binding protein(L-FABP)and albumin creatinine ratio(ACR)in early renal injury in pregnancy induced hypertension syndrome(PHS).Methods A total of 220 gravidas were divided into three groups:pregnancy without hypertension(group A),pregnancy with hypertension and without proteinuria(group B),and pregnancy with hypertension and proteinuria(group C).L-FABP in random urine was analyzed by enzyme linked immunosorbent assay(ELISA).ACR in random urine,plasma cystatin C and plasma creatinine were measured by biochemical process.Results Urinary L-FABP and ACR in group C were significantly higher than those in group B [(45.55±4.2)μg·g~(-1)·Cr~(-1) vs.(5.53±0.55)μg·g~(-1)·Cr~(-1);(146.3±22.6)mg·g~(-1)·Cr~(-1) vs.(8.85±1.52)mg·g~(-1)·Cr~(-1))](P<0.05),and no differences between group A and group B(P>0.05).There was a correlation between the levels of urinary L-FABP and ACR in group C(r=0.802,P<0.05).Conclusion L-FABP in random urine is a sensitive marker in diagnosis of early renal injury in pregnancy-induced hypertension syndrom.Combined detection of urinary L-FABP and ACR can improve the diagnostic sensitivity of early renal injury in patients with pregnancy-induced hypertension syndrom.
引文
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[5]KAMIJO-IKEMORI A,SUGAYA T,KIMURA K.L-type fatty acid binding protein(L-FABP)and kidney disease[J].Rinsho Byori,2014,62(2):163-170.
[6]SCHREZENMEIER E V,BARASCH J,BUDDE K,et al.Biomarkers in acute kidney injury-pathophysiological basis and clinical performance[J].Acta Physiologica,2016,219(3):554-572.
[7]FISEHA T,TAMIR Z.Urinary markers of tubular injury in early diabetic nephropathy[J].Int J Nephrol,2016(2016):4647685.
[8]NEGISHI K,NOIRI E,DOI K,et al.Monitoring of urinary L-type fatty acid-binding protein predicts histological severity of acute kidney injury[J].Am J Pathol,2009,174(4):1154-1159.
[9]HISHIKARI K,KIMURA S,NAKAGAMA S,et al.Urinary liver-type fatty acid-binding protein level as a predictive biomarker of acute kidney injury in patients with acute decompensated heart failure[J].Eur Heart J,2016,37(1):536.
[10]KAMIJO A,SUGAYA T,HIKAWA A,et al.Clinical evaluation of urinary excretion of liver-type fatty acidbinding protein as a marker for the monitoring of chronic kidney disease:a muhieenter trial[J].J Lab Clin Med,2005,145(3):125-133.
[11]WAUGH J,HOOPER R,LAMB E.Spot protein-creatinine ratio and spot albumin-creatinine ratio in the assessment of pre-eclampsia:a diagnostic accuracy study with decision-analytic model-based economic evaluation and acceptability analysis[J].Health Technol Assess,2017,21(61):1-90.
[12]KAMIJO A,SUGAYA T,HIKAWA A,et al.Urinary liver-type fatty acid binding protein as a useful biomarker in chronic kidney disease[J].Mol Cell Biochem,2006,284(1/2):175-182.
[2]PADMA Y,APARNA V B,KALPANA B,et al.Renal markers in normal and hypertensive disorders of pregnancy in Indian women:apilot study[J].Int J Reprod,2013,2(4):514-520.
[3]TAIN Y L,LEE C T,HUANG L T.Long-term effects of maternal citrulline supplement on renal transcription prevention of nitric oxide depletion-related programmed hypertension:the impact of genenutrient interactions[J].Int J Mol Sci,2014,15(12):23255-23268.
[4]孙丽双,肖青,赵庆高,等.高血压早期肾损害相关检测指标[J].中国心血管病研究,2015,13(5):398-400.
[5]KAMIJO-IKEMORI A,SUGAYA T,KIMURA K.L-type fatty acid binding protein(L-FABP)and kidney disease[J].Rinsho Byori,2014,62(2):163-170.
[6]SCHREZENMEIER E V,BARASCH J,BUDDE K,et al.Biomarkers in acute kidney injury-pathophysiological basis and clinical performance[J].Acta Physiologica,2016,219(3):554-572.
[7]FISEHA T,TAMIR Z.Urinary markers of tubular injury in early diabetic nephropathy[J].Int J Nephrol,2016(2016):4647685.
[8]NEGISHI K,NOIRI E,DOI K,et al.Monitoring of urinary L-type fatty acid-binding protein predicts histological severity of acute kidney injury[J].Am J Pathol,2009,174(4):1154-1159.
[9]HISHIKARI K,KIMURA S,NAKAGAMA S,et al.Urinary liver-type fatty acid-binding protein level as a predictive biomarker of acute kidney injury in patients with acute decompensated heart failure[J].Eur Heart J,2016,37(1):536.
[10]KAMIJO A,SUGAYA T,HIKAWA A,et al.Clinical evaluation of urinary excretion of liver-type fatty acidbinding protein as a marker for the monitoring of chronic kidney disease:a muhieenter trial[J].J Lab Clin Med,2005,145(3):125-133.
[11]WAUGH J,HOOPER R,LAMB E.Spot protein-creatinine ratio and spot albumin-creatinine ratio in the assessment of pre-eclampsia:a diagnostic accuracy study with decision-analytic model-based economic evaluation and acceptability analysis[J].Health Technol Assess,2017,21(61):1-90.
[12]KAMIJO A,SUGAYA T,HIKAWA A,et al.Urinary liver-type fatty acid binding protein as a useful biomarker in chronic kidney disease[J].Mol Cell Biochem,2006,284(1/2):175-182.