| Preeclampsia is a pregnancy-related hypertension,which is characterized by hypertension,proteinuria,and different organ system damage, including kidney,liver,brain,heart and lung,and even can lead to fet al growth retardation or death,and occurs after 20 weeks of pregnancy,In addition,preeclampsia in both developed and developing countries has becomea major threat to the maternal and perinatal health.From the view of pathophysiological,not only preeclampsia cause kidney permeability,which increased urinary protein. But also pregnant women are more susceptible to kidney disease which causes preeclampsia.Therefore,rapid diagnosis and early treatment of preeclampsia for renalprotection and prevention of renal damage is essential. However,detection of 24 h urine protein,serum creatinine and other traditinal markers have low specificity and sensitivity,and specimen collect-ion have difficulties.With the discovery and research of urinary KIM-1(u KIM-1),urinary NGAL(u NGAL) and serum cystatin C(s Cystatin C),preeclampsia diagnosis will no longer confined to the traditional detection markers, you can use these new markers of preeclampsia in the early diagnosis and treatment,and to improve their prognosis and reduce maternal and fet al morbidity and mortality.KIM-1 is not existed in normal kidney.when kidney injure,it will increases and may reflect the degree of renal injury.In recent years,it is a sensitive marker of renal tubular injury in the early diagnosis.KIM-1 is currently a large number of experimental studies focused on acute kidney injury after renal is chemia-reperfusion injury and the cause of type 2 diabetes,pre-eclampsia for KIM-1 in kidney injury is currently no research.In recent years,the relationship between NGAL and renal disease increasingly attract the subject of attention.A large number of experiments have confirmed that serum and urinary NGAL is a reliable marker of acute kidney injury and chronic kidney disease.The NGAL Application of preeclampsia is still under exploration.Only some scholars believe that preeclampsia serum NGAL levels rise,which suggest NGAL may be involved in preeclampsia damaging the kidneys.Cystatin C can accurately reflect the glomerular filtration rate. A large number of domestic and international studies have shown that pregnant women with mild preeclampsia in early pregnancy serum cystatin C had significantly higher than the control group,with a certain value for the early diagnosis of preeclampsia and monitor trends.Objective:To investigate the relationship between u KIM-1,u NGAL,s Cystatin C and preeclampsia,the value of predicting preeclampsia and early kidney damage.Methods: Pregnant women with severe preeclampsia 30 cases,30 cases of mild preeclampsia and 60 cases of healthy pregnant women are suspected from October 2014 to July 2015 at the Second Affiliated Hospital of Jilin University.Using ELISA to check u KIM-1 and u NGAL,s Cystatin C are dedected by immune turbidity method.Results:u KIM-1,u NGAL,s Cystatin C in the preeclampsia were significantly higher than the normal controlgroup(P<0.05),and with the development of their concentrations,the progression of preeclampsia gradually rise;BMI,24 h urine protein,urine protein/creatinine ratio,u KIM-1,u NGAL,s Cystatin C are the risk factors for preeclamsia;u KIM-1,u NGAL,s Cystatin C and combined predictors of preeclampsia are taken as the early indicators of renal injury,which sensitivity are separately 83.3%,75%,88.9%,96.8%;specificity are separately 72.7%,70%,75.6%, 86.4%.Conclusion:u KIM-1,u NGAL,s Cystatin C may reflect the progression of renal injury in preeclampsia.Combined predictors have a higher predictive value in the early renal injury of the preeclampsia. |
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