尿钙及尿微量白蛋白检测在妊高征早期诊断中的临床意义

目的　评价尿钙及尿微量白蛋白检测在妊高征早期诊断中的临床意义。方法　收集９８ 例孕２４～３２ 周健康孕妇的２４ 小时尿样,采用自动生化仪测定尿钙排泄量,放射免疫法测定尿微量白蛋白的排泄量,按最终是否发生妊高征分成妊高征组（１４ 例） 和正常妊娠组（８４ 例） 。结果　妊高征组尿钙排泄量为（１－４３±０－３７） ｍｍｏｌ／２４ｈ ,正常妊娠组为（３－２６±０－７５） ｍｍｏｌ／２４ｈ,妊高征组尿钙排泄量显著低于正常妊娠组（ Ｐ＜ ０－００５） 。妊高征组尿微量白蛋白排泄量为（１２－６８ ±６－８１） μｇ／２４ｈ ,正常妊娠组为（６－０８±３－４８） μｇ／２４ｈ,妊高征组尿微量白蛋白排泄量显著高于正常妊娠组（ Ｐ＜ ０－０５）。结论　在妊高征临床症状出现４～８ 周之前,即出现尿钙排泄量减少及尿微量白蛋白排泄量增多。这一特征可作为妊高征早期诊断的指标。

The clinical study on urinary albumin and calcium output in 24 hours to serve as early markers for pregnancy induced hypertension

OBJECTIVE: To assess the efficacy of urinary calcium and albumin output in 24 hours for prediction of the occurrence of pregnancy induced hypertension (PIH). METHODS: 24-hour urine samples were collected at 24-32 weeks' gestation in 98 health women for the measurement of calcium and albumin, at the same time plasma calcium and creatinine were also determined. All patients were followed up until delivery and were classified subsequently according to the occurrence of PIH. Microalbumin was measured by RIA and calcium by automatic biochemistry analysis. RESULTS: The patients in whom PIH developed later (n = 14) had significant lower urinary calcium excretion [(1.43 +/- 0.37) mmol/24 h VS (3.26 +/- 0.75) mmol/24 h] and higher microalbuminuria [(12.68 +/- 6.81) micrograms/24 h VS (6.08 +/- 3.48) micrograms/24 h] as compared with the group which remained normal (n = 84). CONCLUSIONS: The decrease of calcium and increase of albumin per 24 hours of urine were observed 4-8 weeks before the onset of PIH. The above observation may serve as early markers for PIH.