Salmon Lior, Mastrolia Salvatore A, Hamou Batel, Wilkof-Segev Renana, Beer-Weisel Ruthy, Klaitman Vered, Besser Limor, Erez Offer
Department of Obstetrics and Gynecology, Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
Department of Maternal-Fetal Medicine, MBBM Foundation, San Gerardo Hospital, University of Milano Bicocca, Monza, Italy -
Minerva Ginecol. 2018 Jun;70(3):246-253. doi: 10.23736/S0026-4784.17.04131-4. Epub 2017 Oct 9.
The aim of this study was to determine the correlation between the urine protein-creatinine ratio (UPCR) and the 24-hour urine protein excretion test (UPET), and to identify the optimal threshold values of UPCR for the diagnosis of preeclampsia and its severe form.
This prospective cohort study included 81 hypertensive pregnant patients who had a 24-h UPET and a UPCR tests. Two groups were created using a UPCR cut-off of 23.2 mg/mmol (40 negative UPCR, 41 positive UPCR).
Forty-nine patients of were diagnosed with preeclampsia, and 23 of them had a severe disease. There was a significant correlation between UPCR and 24-h UPET. A cut-off UPCR value of 23.2 mg/mmol had an area under the curve (AUC) of 0.27, sensitivity of 89%, specificity 88%, positive predictive value 90%, a positive likelihood ratio (+LR) of 7.41 and a negative likelihood ratio (-LR) of 0.13 for the diagnosis of preeclampsia. UPCR value of 325 mg/mmol had an AUC of 0.841, and a sensitivity of 83%, specificity 81%, positive predictive value 81%, +LR of 4.4 and -LR of 0.2 for the diagnosis of severe preeclampsia.
The UPCR test is highly correlated with the 24-h UPET. We propose a novel and sensitive cut-off for the diagnosis of preeclampsia by UPCR test. The UPCR test can be used for the identification of hypertensive patients with preeclampsia and severe disease.
本研究旨在确定尿蛋白肌酐比值（UPCR）与24小时尿蛋白排泄试验（UPET）之间的相关性，并确定UPCR用于诊断子痫前期及其严重形式的最佳阈值。
这项前瞻性队列研究纳入了81例进行了24小时UPET和UPCR检测的高血压孕妇。使用23.2mg/mmol的UPCR临界值分为两组（40例UPCR阴性，41例UPCR阳性）。
49例患者被诊断为子痫前期，其中23例为重度子痫前期。UPCR与24小时UPET之间存在显著相关性。UPCR临界值为23.2mg/mmol时，诊断子痫前期的曲线下面积（AUC）为0.27，灵敏度为89%，特异性为88%，阳性预测值为90%，阳性似然比（+LR）为7.41，阴性似然比（-LR）为0.13。UPCR值为325mg/mmol时，诊断重度子痫前期的AUC为0.841，灵敏度为83%，特异性为81%，阳性预测值为81%，+LR为4.4，-LR为0.2。
UPCR检测与24小时UPET高度相关。我们提出了一种通过UPCR检测诊断子痫前期的新的敏感临界值。UPCR检测可用于识别患有子痫前期和重度疾病的高血压患者。
