标题：子痫前期与妊娠合并慢性肾脏病孕妇血清同型半胱氨酸、β2微球蛋白和铁蛋白水平比较

      作者：袁媛，吴曼莉，赵敏    汉中市中心医院产科，陕西 汉中 723000

      卷次： 2019年30卷7期

      【摘要】 目的 比较子痫前期(PE)与妊娠合并慢性肾脏病孕妇的血清同型半胱氨酸(Hcy)、β2微球蛋白及铁蛋白水平的差异及其与分娩孕周的相关性。方法 收集2017年2月至2018年2月于汉中市中心医院产科住院的孕妇共136例，其中PE孕妇(PE组) 53例，妊娠合并慢性肾脏病孕妇(肾脏病组) 39例，正常孕妇(对照组) 44例，分别检测并比较三组孕妇血清中Hcy、β2微球蛋白及铁蛋白的水平，并分析PE与妊娠合并肾脏病孕妇血清Hcy、β2微球蛋白及铁蛋白水平与分娩孕周的相关性。结果 (1)三组孕妇的血清Hcy、β2微球蛋白、铁蛋白水平比较：肾脏病组孕妇的血清Hcy水平明显高于PE组及对照组[(8.85±1.98) μmol/L vs (6.21±1.31) μmol/L，(4.21±0.98) μmol/L]，血清β2微球蛋白水平显著高于PE组及对照组[(4.2±2.3) mg/L vs (2.9±0.8) mg/L，(1.7±0.3) mg/L]，血清铁蛋白水平显著低于PE组及对照组[(3.0±0.8) g/L vs (3.7±1.1) g/L，(3.6±0.6) g/L]，差异均有显著统计学意义(P<0.01)；(2) PE组孕妇血清Hcy、β2微球蛋白及铁蛋白水平与分娩孕周的相关性：PE组分娩孕周与Hcy水平无相关性(P>0.05)，与β2微球蛋白水平呈负相关(r=-0.412，P=0.031)，与铁蛋白水平正相关(r=0.368，P=0.030)；(3)肾脏病组孕妇血清Hcy、β2微球蛋白及铁蛋白水平与分娩孕周的相关性：肾脏病组孕妇分娩孕周与Hcy及β2微球蛋白水平呈负相关(Hcy：r=-0.575，P<0.01；β2微球蛋白：r=-0.602，P<0.01)，与铁蛋白水平呈明显正相关(r=0.287，P=0.098)。结论 PE与妊娠合并慢性肾脏病孕妇血清Hcy、β2微球蛋白、铁蛋白的水平存在明显差异，且与分娩孕周相关性不一致，可为PE与妊娠合并慢性肾脏病的诊断提供参考。
      【关键词】 先兆子痫；慢性肾功能不全；同型半胱氨酸；β2微球蛋白；铁蛋白；相关性
      【中图分类号】 R714.24+5 【文献标识码】 A 【文章编号】 1003—6350（2019）07—0832—04

Comparison of serum homocysteine, β2-microglobulin, and ferritin in pre-eclampsia and pregnancies complicatedwith chronic kidney disease.
YUAN Yuan, WU Man-li, ZHAO Min. Department of Obstetrics, Hanzhong Central Hospital,Hanzhong 723000, Shaanxi, CHINA
【Abstract】 Objective To observe the difference of serum homocysteine (Hcy), β 2-microglobulin, and ferritinin pre-eclampsia (PE) and pregnancies complicated with chronic kidney disease. Methods A total of 136 cases of preg-nant woman delivered in Hanzhong Central Hospital from February 2017 to February 2018 were recruited in this study,including 53 cases of pregnancies with PE (PE group), 39 cases of pregnancies with chronic kidney disease (chronic kid-ney disease group), and 44 cases of normal pregnancies with normal blood pressure and proteinuria without any compli-cation (control group). Serum homocysteine, β 2-microglobulin, and ferritin levels were detected. Correlation tests wereconducted between these indicators and delivery weeks. Results (1) Comparison of serum homocysteine, β2-microglobulin andferritin levels in three groups: serum homocysteine level in chronic kidney disease group was (8.85±1.98) μmol/L, significantlyhigher than (6.21±1.31) μmol/L in PE group and (4.21±0.98) μmol/L in control group (P<0.01); serum β2-microglobulinin chronic kidney disease group was (4.2±2.3) mg/L, significantly higher than (2.9±0.8) mg/L in PE group and (1.7±0.3)mg/L in control group (P<0.01); serum ferritin in chronic kidney disease group was (3.0±0.8) g/L, significantly lower than(3.7±1.1) g/L in PE group and (3.6±0.6) g/L in control group (P<0.01). (2) The correlation between serum homocyste-ine, β 2-microglobulin, ferritin and delivery weeks in PE group: delivery weeks were not correlated with serum homo-cysteine (P>0.05), but was negatively correlated with β 2-microglobulin (r=-0.412, P=0.031) and positively correlatedwith ferritin (r=0.368, P=0.030). (3) The correlation between serum homocysteine, β2-microglobulin, ferritin and deliv-ery weeks in chronic kidney disease group: delivery weeks were negatively correlated with serum homocysteine, β2-mi-croglobulin (homocysteine: r=-0.575, β2-microglobulin:r=-0.602, both P<0.01), and positively correlated with ferritin(r=0.287, P=0.098). Conclusion The serum levels of homocysteine, β2-microglobulin, and ferritin in PE and pregnan-cies with chronic kidney disease are significantly different, which may provide clinical value for the diagnosis of PE andpregnancies with chronic kidney disease in future.
      【Key words】 Pre-eclampsia; Chronic renal insufficiency; Homocysteine; β2-Microglobulin; Ferritin; Correlation