CAJ | 학술논문

目的：测定正常孕妇的随机尿白蛋白／肌酐比值（albuminuria to creatinine ratio， ACR），追踪妊娠结局，探讨 ACR 对妊娠期高血压疾病（ hypertensive disorders complicating pregnancy ， HDCP ）的预测价值。方法：随机选择正常孕妇，纳入2038例正常孕妇其中87例后期发生HDCP。测定ACR、血尿常规、血生化，尿蛋白阳性者测定24 h 尿蛋白。结果：发生 HDCP 组 ACR 显著增高，24 h 尿蛋白无明显差异；ACR 与24 h 尿蛋白呈正相关；Losigtic 回归分析显示年龄、孕周、ACR、红细胞、血糖、肌酐、总蛋白是发生 HDCP 的独立危险因素； ACR 预测 HDCP 的 ROC 曲线下面积为0．787，敏感度为0．78，特异度为0．63，最佳值为1．46 mg／mmol。结论：ACR 在 HDCP 前期与24 h 尿蛋白呈正相关，较24 h 尿蛋白敏感，可早期预测 HD-CP。
목적：측정정상잉부적수궤뇨백단백／기항비치（albuminuria to creatinine ratio， ACR），추종임신결국，탐토 ACR 대임신기고혈압질병（ hypertensive disorders complicating pregnancy ， HDCP ）적예측개치。방법：수궤선택정상잉부，납입2038례정상잉부기중87례후기발생HDCP。측정ACR、혈뇨상규、혈생화，뇨단백양성자측정24 h 뇨단백。결과：발생 HDCP 조 ACR 현저증고，24 h 뇨단백무명현차이；ACR 여24 h 뇨단백정정상관；Losigtic 회귀분석현시년령、잉주、ACR、홍세포、혈당、기항、총단백시발생 HDCP 적독립위험인소； ACR 예측 HDCP 적 ROC 곡선하면적위0．787，민감도위0．78，특이도위0．63，최가치위1．46 mg／mmol。결론：ACR 재 HDCP 전기여24 h 뇨단백정정상관，교24 h 뇨단백민감，가조기예측 HD-CP。
Objective To determine the random spot albuminuria to creatinine ratio (ACR) of normal pregnant women , to track the pregnancy outcome , and to discuss the predictive value of ACR in women with hy-pertensive disorders complicating pregnancy (HDCP). Methods Except for 87 pregnant women suffering from HDCP, 2 038 pregnant women were enrolled in this study. ACR, routine examinations of blood and urine, blood biochemical, 24-hr urinary protein were determined. Results ACR, but not 24-hr urinary protein level,was sig-nificantly higher in women with HDCP. There was positive correlation between the ACR and 24-hr urinary protein quantitation. Age, gestational weeks, ACR, red blood cells, fasting plasma glucose, serum creatinine, total pro-tein were the independent risk factors for HDCP. The sensitivity , specificity and optimal cut off value of ACR for predicting HDCP were 0.78, 0.63, 1.46 mg/mmol. Conclusions There was positive correlation between ACR and 24-hr urinary protein quantitation , and ACR provided a more sensitive pathway for early predictionof HDCP.