妊娠期高血压产妇孕中期Scr、BUN及UA水平与急性肾损伤程度的相关性

目的 探讨妊娠期高血压（HDCP）产妇孕中期血清肌酐（Scr）、尿素氮（BUN）及尿酸（UA）水平与急性肾损伤（AKI）程度的相关性。方法 选取2018年2月—2022年1月青海大学附属医院收治的104例HDCP产妇，根据急性透析质量指导组（ADQI）推荐标准将其分为AKI组（36例）和非AKI组（68例），根据RIFLE标准将AKI组分为轻度AKI组（21例）和中重度AKI组（15例），另随机选取同期于本院行常规产检的52例健康妊娠女性纳入健康对照（HC）组。比较AKI组、非AKI组和HC组血清Scr、BUN及UA 水平；比较不同AKI严重程度HDCP产妇血清Scr、BUN和UA水平。受试者操作特征曲线（ROC）检测血清Scr、BUN、UA水平对HDCP产妇并发AKI的诊断效能；Spearman相关性分析血清Scr、BUN、UA水平与HDCP产妇AKI严重程度的关系。结果 AKI组孕中期血清Scr、BUN和UA水平显著高于非AKI组和HC组（P＜0.05）。ROC结果显示，孕中期血清Scr、BUN和UA诊断HDCP并发AKI的曲线下面积（AUC）分别为0.843、0.755和0.847，截断值分别为53.04 μmol/L、4.81 mmol/L和349.35 μmol/L，三者联合检测诊断HDCP并发AKI的AUC为0.876；中重度AKI组孕中期血清Scr、BUN和UA水平均明显高于轻度AKI组（P＜0.05）；Spearman相关性分析提示Scr、BUN、UA与HDCP产妇AKI程度呈正相关（P<0.05）。结论 HDCP并发AKI产妇孕中期血清Scr、BUN和UA水平升高与AKI病情严重程度呈正相关

Correlation between serum creatinine, blood urea nitrogen, uric acid and the severity of acute kidney injury in puerperae with hypertensive disorder complicating pregnancy during second trimester

Objective To explore the correlation between serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA) and the severity of acute kidney injury (AKI) in puerperae with hypertensive disorder complicating pregnancy (HDCP) during second trimester. Methods A total of 104 puerperae with HDCP admitted to the Affiliated Hospital of Qinghai University were enrolled from February 2018 to January 2022. According to recommended criteria in acute dialysis quality initiative group (ADQI), they were divided into AKI group (36 cases) and non-AKI group (68 cases). According to RIFLE criteria, patients in AKI group were divided into mild AKI group (21 cases) and moderate-severe AKI group (15 cases). A total of 52 healthy pregnant women undergoing routine obstetric examination during the same period were enrolled as healthy control (HC) group. The levels of serum Scr, BUN and UA were compared among AKI group, non-AKI group and HC group, and in HDCP puerperae with different severity of AKI. The diagnostic efficiency of serum Scr, BUN and UA for AKI was detected by receiver operating characteristic (ROC) curves. And their relationship with the severity of AKI was analyzed by Spearman correlation analysis. Results The levels of serum Scr, BUN and UA during second trimester in AKI group were significantly higher than those in non-AKI group and HC group (P<0.05). The results of ROC curves analysis showed that area under the curve (AUC) values of serum Scr, BUN and UA in the diagnosis of HDCP complicated with AKI were 0.843, 0.755 and 0.847, respectively. And their cut-off values were 53.04 μmol/L, 4.81 mmol/L and 349.35 μmol/L, respectively. AUC of combined detection was 0.876 (P<0.05). The levels of serum Scr, BUN and UA during second trimester in moderate-severe AKI group were significantly higher than those in mild AKI group (P<0.05). Spearman correlation analysis showed that Scr, BUN and UA were positively correlated with the severity of AKI in HDCP puerperae (P<0.05). Conclusion The levels of serum Scr, BUN and UA increase in puerperae with HDCP and AKI during second trimester, which are positively correlated with the severity of AKI