uKIM-1、uL-FABP水平预测妊娠高血压综合征患者早期肾功能损伤的价值

目的分析尿液肾损伤分子(urinary kidney injury molecules,uKIM-1)、尿液肝型脂肪酸结合蛋白(urine hepatic fatty acid binding protein,uL-FABP)水平预测妊娠高血压综合征(pregnancy induced hypertension syndrome,PIH)患者早期肾功能损伤的价值。方法选取2019年10月-2021年10月于我院就诊的PIH患者100例为研究对象。根据肾小球滤过率(glomerular filtration rate,GFR)将患者分为肾功能损伤组(60 ml/min≤eGFR<90 ml/min,42例)和非肾功能损伤组(eGFR≥90 ml/min,58例)。于入院时测定uKIM-1、uL-FABP水平,借助ROC曲线分析uKIM-1、uL-FABP水平对PIH患者早期肾功能损伤的预测价值。通过一致性分析,评估uKIM-1联合uL-FABP对PIH患者早期肾功能损伤的预测价值。结果肾功能损伤组uKIM-1、uL-FABP水平显著高于非肾功能损伤组,差异有统计学意义(P<0.05)。经ROC曲线分析,uKIM-1、uL-FABP水平预测PIH患者早期肾功能损伤的曲线下面积(AUC)分别为0.834、0.894,均P<0.05。经一致性分析,100例联合检查阳性39例,敏感度为0.929,特异度为0.931,准确率为0.930,Kappa为0.857。结论uKIM-1、uL-FABP水平均可用于PIH患者早期肾功能损伤的预测,且联合检查可获得更好的敏感度、特异度,有临床推广价值。

Predictive value of uKIM-1 and uL-FABP levels on early renal function injury in patients with pregnancy-induced hypertension syndrome

Objective To analyze the value of urinary kidney injury molecules (uKIM-1) and urinary hepatic fatty acid binding protein(uL-FABP) in predicting early renal damage in patients with pregnancy induced hypertension syndrome(PIH). Methods Totally 100 PIH inpatients from October 2019 to October 2021 were included in the study, the patients were divided into renal function injury group (60 ml/min≤eGFR<90 ml/min, 42 cases) and non renal function injury group (eGFR≥90 ml/min, 58 cases) based on glomerular filtration rate(GFR). The levels of uKIM-1 and uL-FABP on admission were measured, ROC was used to analyze the predictive value of uKIM-1 and uL-FABP levels for early renal damage in PIH patients. The predictive value of uKIM-1 combined with uL-FABP on early renal damage in PIH patients were assessed by consistency analysis. Results The levels of uKIM-1 and uL-FABP were significantly higher in renal function injury group than in non renal function injury group, and the difference was statistically significant (P<0.05). The receive operating characteristic(ROC) curve analysis showed that the area under the curve(AUC) of uKIM-1 and uL-FABP in predicting early renal damage in PIH patients were 0.834 and 0.894 respectively (all P<0.05). The result of the consistency analysis showed that totally 39 positive involved out of 100 cases, with 0.929 for sensitivity, 0.931 for specificity, 0.930 for accuracy, and 0.857 for kappa. Conclusion The levels of uKIM-1 and uL-FABP can be used to predict early renal damage in PIH patients, and the combined examination can obtain better sensitivity and specificity, which has the value of clinical promotion.