Abebe J, Eigbefoh J, Isabu P, Okogbenin S, Eifediyi R, Okusanya B
Department of Obstetrics and Gynecology, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
J Obstet Gynaecol. 2008 Jul;28(5):496-500. doi: 10.1080/01443610802196880.
The presence of protein in hypertensive disorders of pregnancy is a sign of a worsening condition and thus requires early intervention to prevent adverse consequences. Accurate assessment of proteinuria in patients with pre-eclampsia will ensure prompt and timely intervention to reduce or prevent the maternal and perinatal morbidity and mortality associated with pre-eclampsia. This study compared the reliability and validity of the more rapid diagnostic tests, such as the dipstick, 2-h and 12-h protein estimations with the 24-h protein. The result of the dipstick, 2-h and 12-h urine were also compared with the 24-h urine results using confidence interval (CI) for proportions with a value of p < 0.05 considered significant (CI 95%). When compared with the gold standard, there was a high degree of correlation between the 2-h (p = 0.244, CI 95%) and 12-h (p < 0.0255, CI 95%) with the 24-h sample in the quantification of proteinuria in women with pre-eclampsia. The most sensitive and specific test was the 12-h protein estimation, (89%) and (93%), respectively. The least sensitive and specific test was the dipstick test; (81%) and (47%), respectively. The 12-h protein estimation test had the highest positive predictive value (84%). The 12-h protein test also had the lowest false positive rate (12%) and false negative rates (11%), respectively. The most accurate test was the 12-h protein estimation (88%). The dipstick tests were however much cheaper and the results were faster. It is recommended that routine rapid quantisation of proteinuria in patients with pre-eclampsia be done using either the 2-h or 12-h urine sample.
妊娠期高血压疾病患者出现蛋白尿是病情恶化的迹象，因此需要早期干预以预防不良后果。准确评估子痫前期患者的蛋白尿情况将确保及时进行干预，以降低或预防与子痫前期相关的孕产妇和围产儿发病率及死亡率。本研究比较了更快速诊断试验（如试纸法、2小时和12小时尿蛋白测定）与24小时尿蛋白测定的可靠性和有效性。还使用比例的置信区间（CI）将试纸法、2小时和12小时尿样结果与24小时尿样结果进行比较，p值<0.05被认为具有统计学意义（CI 95%）。与金标准相比，子痫前期女性蛋白尿定量中，2小时（p = 0.244，CI 95%）和12小时（p < 0.0255，CI 95%）与24小时样本之间存在高度相关性。最敏感和特异的试验是12小时尿蛋白测定，敏感性和特异性分别为（89%）和（93%）。最不敏感和特异的试验是试纸法，敏感性和特异性分别为（81%）和（47%）。12小时尿蛋白测定试验的阳性预测值最高（84%）。12小时尿蛋白试验的假阳性率（12%）和假阴性率（11%）也最低。最准确的试验是12小时尿蛋白测定（88%）。然而，试纸法检测成本低得多，且结果出得更快。建议对子痫前期患者的蛋白尿进行常规快速定量时，使用2小时或12小时尿样。
