| Purpose:To investigate the clinical significance of serum cystatin C,NT-proBNP and urine microalbumin/urine creatinine in the diagnosis of kidney injury in hypertensive disorders of pregnancy.Methods:The pregnant women who were hospitalized in the First Affiliated Hospital of Nanchang University from October 2019 to February 2021 were selected as the research subjects,and according to the "Guidelines for the Diagnosis and Treatment of Hypertension in Pregnancy(2020)",they were divided into gestational hypertension group(n=30)and preeclampsia group(n=60),and normal pregnant women who were hospitalized during the same period were selected as the control group(n=30).From all the pregnant woman,three tubes of 3 ml cubital venous blood were collected with fasting at 6 a.m.in the second day of the hospital to test serum CysC,NT-proBNP and creatinine respectively.10 ml of morning clean midstream urine was collected to test UACR.After emptying the bladder,the patient was instructed to start taking 24-hour urine to test 24-hour urine protein quantification.Using SPSS 25.0 software to analyze the differences in serum CysC,NT-proBNP and UACR between control group,gestational hypertension group and preeclampsia group,then divide all subjects into kidney injury group and non-kidney-injury group according to the diagnostic criteria for renal disfunction of "Guidelines for the Diagnosis and Treatment of Hypertension in Pregnancy(2020)",compare the differences in serum CysC,NT-proBNP and UACR between the two groups.Comparing the correlation between each index and 24 h urine protein,and analyzing the value of the detection of serum CysC,NT-proBNP and UACR alone and in combination in the diagnosis of kidney injury in hypertensive disorders of pregnancy.Results:(1)Serum CysC,NT-proBNP and UACR levels were the highest in the preeclampsia group,and were statistically significant compared with the control group and the gestational hypertension group;(2)In the kidney injury group,the levels of CysC,proBNP and UACR were significantly higher than those in the non-kidney-injury group,and the difference was statistically significant;(3)Grouped by blood pressure,compared with control group,the increase of hypertension group B(systolic blood pressure ≥160mm Hg and/or diastolic blood pressure ≥110mm Hg)in serum CysC,NT-proBNP and UACR levels was statistically significant.The serum CysC level of hypertension group B was higher than hypertension group A(140mm Hg≤systolic blood pressure<160mm Hg and(or)90mm Hg ≤diastolic blood pressure≤110mm Hg),but the difference was not significant(P>0.05).The level of NT-proBNP in hypertension group A was higher than that in control group,and the difference was not significant(P>0.05).(4)Serum CysC,NT-proBNP and UACR levels are positively correlated with 24 h urine protein quantification.(5)Serum CysC,NT-proBNP and UACR are better than creatinine in the diagnosis of kidney injury in hypertensive disorders of pregnancy.The sensitivity,specificity and accuracy of UACR are the highest when detecting UACR alone.When combined detection of CysC,NT-proBNP and UACR,the area under the ROC curve reached the maximum for which was 0.952,and the sensitivity and specificity were 100% and 80.2%.Conclusions:(1)Serum CysC,NT-proBNP and UACR levels can reflect the renal function of patients,and have a certain diagnostic value for kidney injury in hypertensive disorders of pregnancy.(2)The combined detection of CysC,NT-proBNP and UACR can improve the sensitivity,specificity and accuracy of diagnosis,and has better application value than creatine in the diagnosis of renal injury related to hypertensive disorders of pregnancy.And it is more convenient than 24 h urine protein,and has better value for rapid diagnosis of emergency patients. |
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