天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (7): 777-781.doi: 10.11958/j.issn.0253-9896.2015.07.021

• 临床研究 • 上一篇    下一篇

随机尿白蛋白/肌酐比值在妊娠期高血压疾病中的诊断价值

阴红，钟梅   

  1. 1 广州， 南方医科大学附属南方医院妇产科
    2广东中山， 南方医科大学附属小榄医院妇产科

  • 收稿日期:2015-02-02 修回日期:2015-04-29 出版日期:2015-07-15 发布日期:2015-07-15
  • 通讯作者: 钟梅 1 E-mail:zhongmei@fimmu.com
  • 基金资助:
    尿蛋白定量联合尿白蛋白/肌酐比值在妊娠期高血压疾病中的诊断价值

Diagnostic value of random spot urine albumin/creatinine ratio in women with hypertensivedisorders complicating pregnancy

YIN Hong, ZHONG Mei   

  1. 1Department of Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 
    2 Department of Obstetrics, Xiaolan Hospital, Southern Medical University



  • Received:2015-02-02 Revised:2015-04-29 Published:2015-07-15 Online:2015-07-15
  • Contact: ZHONG Mei1 E-mail:zhongmei@fimmu.com
  • Supported by:
    Diagnostic value of random spot albuminuria to creatinine ratio and urine protein quantitative in women with hypertensive disorders complicating pregnancy

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摘要： 摘要： 目的 探讨随机尿白蛋白/肌酐比值（ACR）与 24 h 尿蛋白等指标的相关性， 及其在妊娠期高血压疾病（HDCP）中的诊断价值。 方法 测定并比较 584 例 HDCP 患者（其中妊娠期高血压组 169 例， 轻度子痫前期组 205例、重度子痫前期组 173 例及慢性高血压组 37 例）和 2 038 例正常单胎孕妇（正常组）ACR、24 h 尿蛋白及其他生化指标的差异， 对 ACR 与 24 h 尿蛋白等进行相关分析， 受试者工作曲线（ROC）分析 ACR 诊断 HDCP 的敏感度和特异
度， ROC 曲线下面积得出 ACR 诊断 HDCP 的最佳诊断值。 结果 （1）重度子痫前期组比其他亚组 ACR、24 h 尿蛋白、尿素氮、肌酐、尿酸、总胆固醇、低密度脂蛋白胆固醇显著增高， 血小板计数、白蛋白、总蛋白显著降低（P < 0.05）。（2）ACR 与 24 h 尿蛋白、尿素氮、肌酐、尿酸、D 二聚体、总胆固醇、低密度脂蛋白胆固醇呈正相关（P < 0.05）； 与白蛋白、总蛋白、血小板计数呈负相关（P < 0.05）。（3）ACR 诊断妊娠期高血压、轻度子痫前期、重度子痫前期及极重度子痫前期的最佳值分别为 1.44 、10.48、39.84 及 94.91 g/mol。 结论 ACR 在 HDCP 中与 24 h 尿蛋白高度相关， 可用于诊断 HDCP 及判断病情严重程度。


关键词: 高血压,  妊娠并发症, 心血管 , 白蛋白尿, 肌酸酐, 尿分析, 诊断技术, 妇产科

Abstract: Objective Determined random spot albuminuria to creatinine ratio(ACR) ，24 hours urinary protein and other biochemical indicators. Other biochemical indicators, analyzed the correlation of them, to discuss the diagnostic value of ACR in women with hypertensive disorders complicating pregnancy. Methods 584 women with hypertensive disorders complicating pregnancy including 169 gestational hypertension, 205 mild preeclampsia, 173 severe preeclampsia, 37 chronic hypertension complicating pregnancy and 2038 normal pregnant women were collected over the same time. ACR, 24 hours urinary protein, routine examination of blood and urine, coagulative function, liver and kidney function, fasting plasma glucose, glycated hemoglobin, insulin, C-Peptide, lipids were determined and compared in all the cases. Bivariate correlation analysis was used to analyze the relationship of ACR, 24 hours urinary protein quantitative and other biochemical indicators. To identify the independent risk factor of hypertensive disorders complicating pregnancy on logistic regression analysis. Receiver operating characteristic (ROC) curve was used to analyze the sensitivity, specificity and optimal cut off value of ACR for predicting hypertensive disorders complicating pregnancy. Results （1）ACR, 24 hours urinary protein quantitative, blood urea nitrogen, serum creatinine, uric acid, total cholesterol, low density lipoprotein cholesterol (BUN, Cr, UA, TC, LDL) were significantly higher in women with severe preeclampsia, however, platelet (PLT), serum albumin, total protein were significantly lower. In women with mild preeclampsia group, ACR, 24 hours urinary protein quantitative, UA was significantly higher, while serum albumin significantly lower than that in the other two groups.（2）There were positive correlation between the ACR and 24 hours urinary protein quantitative, urea nitrogen, serum creatinine, UA, D-dimer, TC, LDL (r=0.94, 0.37, 0.35, 0.61, 0.12, 0.33, 0.31, p＜0.05 ), while negative correlation between ACR and serum albumin, total protein, PLT (r=-0.46, -0.40, -0.12, p＜0.05 ) （3）Area under curve (AUC), sensitivity, specificity and optimal cut off value of ACR for predicting gestational hypertension, mild preeclampsia, severe preeclampsia ( 24 hours urinary protein quantitative≥2g) severe preeclampsia ( 24 hours urinary protein quantitative≥5g) were 0.823, 0.89, 0.61, 1.44mg/mmol, 0.988, 0.97, 0.96, 10.48 mg/mmol, 0.978, 0.97, 0.88, 39.84 mg/mmol, 0.973, 0.95, 0.87, 94.91 mg/mmol separately. Conclusions There was positive correlation between ACR and 24 hours urinary protein quantitative. ACR could be used for diagnosing and estimating the severity degree of hypertensive disorders complicating pregnancy.

Key words: hypertension, pregnancy complications, cardiovascular, urinary albumin, creatinine, urinalysis, diagnostic
techniques, obstetrical and gynecological