摘要
目的:探讨血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和基质金属蛋白酶13(MMP-13)水平变化对妊娠期糖尿病肾病的早期诊断及预后价值。方法:选择2017年4月-2018年9月本院就诊的妊娠期糖尿病孕妇97例(观察组)及同期产前检查健康孕妇97例(对照组)。根据尿微量白蛋白排泄率(UAER)将观察组分成3个亚组(前期、早期和临床),检测各组血清尿素氮(BUN)及血清肌酐(CREA)、NGAL及MMP-13,探讨NGAL、MMP-13在妊娠期糖尿病肾病不同期变化及与尿UMA相关性,ROC曲线分诊断妊娠期糖尿病肾病效能。结果:观察组NGAL、BUN、CREA及尿UMA均高于对照组,MMP-13低于对照组(P<0.05)。观察组中肾损害临床组NGAL、BUN、CREA及尿UMA高于、MMP-13低于前期组和早期组,早期组NGAL及尿UMA高于前期组、MMP-13低于前期组(均P<0.05),BUN及CREA前期组与早期组无差异(P>0.05)。观察组血清NGAL与尿UMA水平呈显著正相关关系(r=0.532,P=0.005),血清MMP-13与尿UMA呈显著负相关(r=-0.429,P=0.025)。ROC分析显示NGAL、MMP-13联合诊断妊娠期糖尿病肾病的曲线下面积(AUC)0.851(95%CI:0.853-0.991,P=0.000),灵敏度94.4%、特异度95.1%。结论:联合检测血清NGAL和MMP-13可用于妊娠期糖尿病肾病早期诊断及预后预测。
Objective:To investigate the value of early diagnosis and prognostic evaluation of the levels of serum NGAL and MMP-13 of pregnant women with gestational diabetic nephropathy.Methods:97 pregnant women with gestational diabetic nephropathy(in observation group)and 97 healthy pregnant women(in control group)were enrolled in this study from April 2017 to September 2018.In the observation group,the women were divided into group A,B and C according to the urinary albumin excretion rate(UAER)of women.The levels of serum urea nitrogen(BUN)and creatinine(CREA),neutrophil gelatinase associated lipids carry proteins(NGAL),and matrix metalloproteinase(MMP)-13 of women in these groups were detected.The changes of the NGAL and MMP-13 levels of women during different stages of gestational diabetic nephropathy and the correlate with their urine UMA level were analyzed.ROC curve was used to analyze the diagnostic efficacy of gestational diabetic nephropathy.The levels of serum NGAL,BUN,and CREA,and the urine UMA of women in the observation group were significant higher than those of women in the control group,but the MMP-13 level was significant lower than that of women in the control group(P<0.05).In the observation group,the average levels of serum NGAL,BUN,and CREA,and urine UMA of women in group C were significant higher than those of women in group A and B,but the MMP-13 level was significant lower than that of women in group A.The serum NGAL level and urine UMA level of women in group B were significant higher than those of women in group A,but the MMP-13 level was significant lower than that of women in group A(all P<0.05).There were no significant different in the levels of BUN and CREA of women between group A and B(P>0.05).In the observation group,there was significant positive correlation between serum NGAL level and urine UMA level(r=0.532,P=0.005),and there was significant negative correlation between serum MMP-13 level and urine UMA level(r=-0.429,P=0.025).ROC analysis showed that the area under the curve(AUC),the
作者
石节丽
韩颖
付娜
张琳
高鹏飞
SHI Jieli;HAN Ying;FU Na;ZHANG Lin;GAO Pengfei(Tianjin Haibin People's Hospital, Tianjin, 300280)
出处
《中国计划生育学杂志》
2020年第6期839-842,共4页
Chinese Journal of Family Planning
关键词
妊娠期糖尿病肾病
中性粒细胞明胶酶相关脂质运载蛋白
基质金属蛋白酶13
早期诊断
预后预测
诊断效能
Gestational diabetic nephropathy
Serum neutrophil gelatinase associated lipids carry proteins
Matrix metalloproteinase-13
Early Diagnosis
Prognosis Prediction
Diagnositic efficacy
