韦丽淑++李素芬++罗文婷

【摘要】目的探討妊娠高血压疾病（HDP）患者血清胱抑素C（CysC）、超敏C反应蛋白（hsCRP）和β2微球蛋白（β2MG）浓度检测的临床意义。

方法收集2015年12月～2016年12月在妇产科进行产前检查并住院分娩的HDP患者95例。根据HDP严重程度分为轻度组37例，中度组28例，重度组30例。另外选择同期正常妊娠孕产妇35例纳入正常组。同时根据血肌酐（Ccr）水平将HDP患者分为肾功能受损组（Ccr<80 ml/min）42例和肾功能正常组（Ccr≥80 ml/min）53例。对比各组血清CysC、hsCRP、β2MG浓度差异，分析三个指标与HDP严重程度及肾功能损伤的关系。

结果轻度组、中度组、重度组的血清CysC、hsCRP、β2MG浓度均高于正常组（P<0.01），中度组、重度组的血清CysC、hsCRP、β2MG浓度均高于轻度组（P<0.01），重度组的血清CysC、hsCRP、β2MG浓度均高于中度组（P<0.01）。HDP患者血清CysC与hsCRP呈正相关性（r=0.614，P<0.001），与β2MG呈正相关性（r=0.652，P<0.001）。肾功能损伤组HDP患者血清CysC、hsCRP、β2MG浓度高于肾功能正常组（P<0.001）。

结论HDP的发生与CysC、hsCRP和β2MG浓度改变有关，且随病情程度的加重而升高，可作为HDP发生早期及肾功能损伤诊断的敏感指标，动态监测孕产妇血清CysC、hsCRP和β2MG浓度变化对HDP发生及肾功能损伤的早期诊断和指导临床治疗具有极高的临床价值。

【关键词】妊娠高血压疾病；胱抑素C；超敏C反应蛋白；β2微球蛋白；肾损害

中图分类号：R714.24+6文献标识码：ADOI：10.3969/j.issn.10031383.2017.05.010

Clinical significance of detection of serum CysC，hsCRP and β2MGconcentrations in patients with HDP

[HJ2][HJ]

WEI Lishu，LI Sufen，LUO Wenting

（Laboratory Department，Liuzhou Municipal Liutie Central Hospital，Liuzhou 545007，China）

[HJ2][HJ]

【Abstract】ObjectiveTo investigate the clinical significance of detection of serum CysC，hsCRP and β2MG concentrations in patients with hypertensive disorder complicating pregnancy（HDP）.

Methods95 patients with HDP undergoing prenatal examination and delivery in obstetrics and gynecology department from December，2015 to December，2016 were collected.According to the severity of HDP，they were divided into mild group（n=37），moderate group（n=28）and severe group（n=30）.In addition，35 normal pregnant women were enrolled in the normal group.At the same time，according to serum creatinine（Ccr）levels，HDP patients were divided into impaired renal function group（Ccr<80 ml/min）（n=42）and normal renal function group（Ccr≥80ml/min）（n=53）.The differences of serum CysC，hsCRP，and β2MG concentrations among the groups were compared，and relationship between the three abovementioned indexes and the severity of HDP and the impairment of renal function was analyzed.

ResultsThe serum CysC，hsCRP and β2MG concentrations in the mild group，the moderate group and the severe group were higher than those in the normal group（P<0.01），those of the moderate group and the severe group were significantly higher than those in the mild group（P<0.01），and those of the severe group were higher than those in the moderate group（P<0.01）.The serum CysC was positively correlated with hsCRP（r=0.614，P<0.001），and was also positively correlated with β2MG in patients with HDP（r=0.652，P<0.001）.The serum CysC，hsCRP，and β2MG concentrations in the renal function impairment group were higher than those in the normal renal function group（P<0.001）.endprint

ConclusionThe occurrence of HDP is related to the change of the concentrations of CysC，hsCRP and β2MG，and they increase with the severity of the disease，which can be used as sensitive indicators for the early diagnosis of HDP and renal dysfunction.Dynamic monitoring for maternal serum CysC，hsCRP and β2MG concentrations has very high clinical value on the early diagnosis and guidance of clinical treatment of HDP and renal injury.

【Key words】HDP；CysC；hsCRP；β2MG；renal injury

妊娠高血压疾病（HDP）是妇女妊娠期间特有的一种疾病，其对围产期母婴生命健康造成了极大的威胁，它可引起患者各组织器官血流灌注，导致缺血性终末器官的损害，诱发流产、早产和胎死宫中等严重并发症[1]。故在HDP发生早期明确诊断和及时治疗对改善母婴健康具有积极意义。本研究对95例HDP患者血清胱抑素C（CysC）、超敏C反应蛋白（hsCRP）和β2微球蛋白（β2MG）浓度进行检测，以了解三者浓度改变对HDP的诊断价值。

1对象与方法

1.1研究对象

收集2015年12月～2016年12月在我院妇产科进行产前检查并住院分娩的HDP患者95例。诊断参照乐杰主编的第7版《妇产科学》中有关HDP的诊断标准[2]。排除标准：糖尿病患者，慢性高血压或有症状的传染性疾病，严重肾功能不全者。……