Sethuram R, Kiran T S Usha, Weerakkody A N A
Department of Obstetrics and Gynaecology, Royal Gwent Hospital, Newport, South Wales, UK.
J Obstet Gynaecol. 2011;31(2):128-30. doi: 10.3109/01443615.2010.538771.
The objective of this study was to assess the value of the spot protein/creatinine ratio as the diagnostic test for pre-eclampsia by correlating it to the 24 h urine protein. For the spot test, this study uses the cut-off value recognised by the International Society for the Study of Hypertension in Pregnancy (ISSHP). Ours was a correlational study made in the setting of the antenatal assessment unit/antenatal ward in a District General Hospital. Patients at >24 weeks' gestation with hypertension and >1+ proteinuria (n = 32) were included in the study. A 10 ml sample of urine was collected for the spot protein/creatinine ratio (PCR) before the 24 h collection was started. Spot PCR samples were stored at -18°C until the end of the study period. The results of the spot PCR were correlated to 24 h results using Pearson's correlation coefficient. Main outcome measures were correlation coefficient, sensitivity, specificity, positive and negative predictive values. Correlation was significant (r(2) = 0.82). Sensitivity, 83%; specificity, 92%; positive likelihood ratio, 10.3; negative likelihood ratio, 0.18. The spot PCR correlates well to the 24 h urine protein. The new cut-off values recognised by the ISSHP are producing consistent results. The evidence in favour of the spot PCR needs to be reassessed by larger studies.
本研究的目的是通过将随机尿蛋白/肌酐比值与24小时尿蛋白进行关联，评估其作为子痫前期诊断试验的价值。对于随机尿检测，本研究采用了国际妊娠高血压研究学会（ISSHP）认可的临界值。这是一项在地区综合医院的产前评估单元/产前病房进行的相关性研究。纳入研究的患者为妊娠>24周且患有高血压和蛋白尿>1+（n = 32）。在开始收集24小时尿液之前，采集10毫升尿液样本用于检测随机尿蛋白/肌酐比值（PCR）。随机尿PCR样本保存在-18°C直至研究期结束。使用Pearson相关系数将随机尿PCR结果与24小时结果进行关联。主要观察指标为相关系数、敏感性、特异性、阳性和阴性预测值。相关性显著（r(2)=0.82）。敏感性为83%；特异性为92%；阳性似然比为10.3；阴性似然比为0.18。随机尿PCR与24小时尿蛋白相关性良好。ISSHP认可的新临界值产生了一致的结果。支持随机尿PCR的证据需要通过更大规模的研究重新评估。
