Department of Obstetrics and Gynecology, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Peking Union Medical College Hospital, Beijing, China.
J Clin Hypertens (Greenwich). 2024 Apr;26(4):349-354. doi: 10.1111/jch.14783. Epub 2024 Mar 2.
To compare the urine Congo-red dot paper test (CRD) with dipstick urinalysis to screen preeclampsia (PE). A total of 409 paired spot urine samples were obtained prospectively from women with suspected pre-eclampsia attending for routine hospital visits. Congo-red dot paper test and dipstick urinalysis were examined and compared to screen pre-eclampsia. The agreement between the two urinary test is modest (kappa coefficient = 0.28, 95% CI 0.14-0.42). The specificity of CRD was higher than urinalysis (97.4% vs. 90.4%, p < .001). Urinalysis performed better in sensitivity (77.3% vs. 40.9%, p = .04) and the area under the receiver operating characteristic curves (AUC) (0.84 [95% CI 0.74-0.94] vs. 0.69 [95% CI 0.55-0.83], p = .04) than CRD, respectively. The sensitivity, specificity, AUC of the parallel test of them is 86.4% (64.0%-96.4%), 89.1% (85.5%-92.0%), and 0.88 (95% CI 0.79-0.96). And the serial test is 31.8% (14.7%-54.9%), 98.7% (96.8%-99.5%), 0.65 (95% CI 0.51-0.79), accordingly. The urinalysis is a better diagnosing test for preeclampsia. CRD could aid in the diagnosis of patients with preeclampsia. Combined the two tests in suspected patients may further improve the performance in the diagnosis of preeclampsia. Further study need to be made for its potential clinical practice.
比较刚果红点纸试验(CRD)与尿干化学分析用于筛查子痫前期(PE)的效果。方法:前瞻性收集疑似子痫前期患者的 409 对随机尿液标本,分别进行 CRD 和尿干化学分析,比较两种方法用于筛查子痫前期的效果。结果:CRD 与尿干化学分析的符合率中等(kappa 系数=0.28,95%CI 0.14-0.42)。CRD 的特异度高于尿干化学分析(97.4% vs. 90.4%,P<.001),但尿干化学分析的敏感度更高(77.3% vs. 40.9%,P=0.04),曲线下面积更大(0.84[95%CI 0.74-0.94] vs. 0.69[95%CI 0.55-0.83],P=0.04)。两者平行联合检测的敏感度、特异度和曲线下面积分别为 86.4%(64.0%-96.4%)、89.1%(85.5%-92.0%)和 0.88(95%CI 0.79-0.96),串联检测的敏感度、特异度和曲线下面积分别为 31.8%(14.7%-54.9%)、98.7%(96.8%-99.5%)和 0.65(95%CI 0.51-0.79)。结论:尿干化学分析用于子痫前期的诊断效能优于 CRD,但 CRD 可辅助子痫前期的诊断。对疑似患者联合两种检测方法可能进一步提高子痫前期的诊断效能,尚需进一步研究其在临床中的应用价值。