利用尿蛋白-肌酐或钙-肌酐比值预测高血压妊娠中的蛋白尿。
Predicting proteinuria in hypertensive pregnancies with urinary protein-creatinine or calcium-creatinine ratio.
作者信息
Rizk D E E, Agarwal M M, Pathan J Y, Obineche E N
机构信息
Department of Obstetrics and Gynecology, United Arab Emirates University, Al-Ain, UAE.
出版信息
J Perinatol. 2007 May;27(5):272-7. doi: 10.1038/sj.jp.7211689.
OBJECTIVE
Evaluate the value of random urinary protein-creatinine (PrCr) and calcium-creatinine (CaCr) ratios to predict 24-h proteinuria in hypertensive pregnancies.
STUDY DESIGN
Spot urine samples were collected before routine 24-h urine collections from consecutive pregnant women with hypertension (n=83). Reliability of spot urinary PrCr and CaCr to detect significant proteinuria (>or=300 mg/day) using 24-h urine protein as 'gold-standard' was assessed by receiver-operating characteristic (ROC) curve.
RESULTS
Fifty-one patients (61.4%) had significant proteinuria (45 pre-eclampsia, 5 superimposed pre-eclampsia, 1 renal hypertension). Area under ROC curve to predict proteinuria was 0.82 (95% confidence interval (CI) 0.73 to 0.92, P<0.001) for PrCr and 0.55 (95% CI 0.43 to 0.68, P=0.2) for CaCr. A cutoff value of >0.19 for PrCr best predicted significant proteinuria with sensitivity, specificity, positive and negative predictive values and likelihood ratios (positive and negative), respectively, of 80.4, 68.8, 80.4, 68.8%, 2.57 and 3.51.
CONCLUSION
Spot urinary PrCr predicts total urinary protein excretion in hypertensive pregnancies.
目的
评估随机尿蛋白-肌酐（PrCr）和钙-肌酐（CaCr）比值预测高血压妊娠中24小时蛋白尿的价值。
研究设计
在连续的高血压孕妇（n = 83）进行常规24小时尿液收集之前收集即时尿样本。以24小时尿蛋白作为“金标准”，通过受试者操作特征（ROC）曲线评估即时尿PrCr和CaCr检测显著蛋白尿（≥300mg/天）的可靠性。
结果
51例患者（61.4%）有显著蛋白尿（45例先兆子痫，5例叠加先兆子痫，1例肾性高血压）。PrCr预测蛋白尿的ROC曲线下面积为0.82（95%置信区间（CI）0.73至0.92，P<0.001），CaCr为0.55（95%CI 0.43至0.68，P = 0.2）。PrCr>0.19的临界值对显著蛋白尿的预测最佳，其敏感性、特异性、阳性和阴性预测值以及似然比（阳性和阴性）分别为80.4%、68.8%、80.4%、68.8%、2.57和3.51。
结论
即时尿PrCr可预测高血压妊娠中的总尿蛋白排泄。
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