血清VEGF、FABP4在妊娠期糖尿病早期肾损害诊断中的价值

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英文篇名：The value of serum VEGF and FABP4 levels for diagnosing renal damage early of pregnant women with gestational diabetes mellitus 作者：郑彦强 ; 王俊芳 ; 王爱华 英文作者：ZHENG Yanqiang;WANG Junhua;WANG Aihua;Handan City Maternal and Child Health Care Hospital,Hubei Province; 关键词：VEGF ; FABP4 ; 妊娠期糖尿病 ; 早期肾损害 英文关键词：VEGF;;FABP4;;Gestational diabetes mellitus;;Renal damage early 中文刊名：JHSY 英文刊名：Chinese Journal of Family Planning 机构：河北省邯郸市妇幼保健院; 出版日期：2019-01-15 出版单位：中国计划生育学杂志 年：2019 期：v.27 语种：中文; 页：JHSY201901023 页数：4 CN：01 ISSN：11-4550/R 分类号：75-78

摘要

目的:探讨血清血管内皮生长因子(VEGF)和脂肪细胞型脂肪酸结合蛋白(FABP4)在妊娠期糖尿病(GDM)早期肾损害的诊断价值。方法:选择63例GDM患者为观察组,42例正常孕妇为对照组,以尿白蛋白排泄率(UAER)为标准,将观察组分为正常蛋白尿组(16例,UAER<20μg/min),微量白蛋白尿组(23例,20μg/min200μg/min),检测各组血清VEGF、FABP4,受试者工作特征曲线(ROC)分析VEGF、FABP4诊断GDM早期肾损害的效能。结果:血清VEGF、FABP4水平大量蛋白尿组>微量蛋白尿组>正常蛋白尿组(P<0.05)。VEGF、FABP4阳性检出率微量蛋白尿组>正常蛋白尿组(P<0.05)。VEGF、FABP4及联合诊断GDM早期肾损害的灵敏度、特异度、准确度、曲线下面积(AUC)分别为72.4%、72.3%、79.4%、0.617(95%CI0.729～0.931);79.4%、72.8%、81.8%、0.729(95%CI 0.617～0.872);89.4%、82.8%、83.8%、0.894(95%CI 0.829～0.941)。结论:GDM患者肾损害时早期外周血清VEGF、FABP4可出现显著增高,VEGF、FABP4检测有助于诊断GDM早期肾损伤,为临床诊治提供参考依据。
        Objective:To investigate the value of levels of serum vascular endothelial growth factor(VEGF)and adipocyte fatty acid binding protein(FABP4)for diagnosing renal damage early of pregnant women with gestational diabetes mellitus(GDM).Methods:Sixty-three patients with GDM were selected in study group,and 42 normal pregnant women were in control group.In study group,the pregnant women were also divided into normal proteinuria group(16cases,UAER<20μg/min).microalbuminuria group(23cases,20μg/min200μg/min)based on the urinary albumin excretion rates(UAER).The levels of serum VEGF and FABP4 of all included women were detected and compared.The test-worker characteristic curve(ROC)was used to analyze the efficacy of VEGF and FABP4 levels for diagnosing the renal damage early of pregnant women with GDM.Results:The serum VEGF,FABP4 levels of pregnant women in large proteinuria group were significant than those of pregnant women in microalbuminuria group,and the serum VEGF,FABP4 levels of pregnant women in microalbuminuria group were significant than those of pregnant women in normal proteinuria group(P>0.05).The positive rates of VEGF,FABP4 detection of pregnant women in microalbuminuria group were significant higher than those of pregnant women in normal proteinuria group(P>0.05).The sensitivity,specificity,accuracy,and area under the curve(AUC)of detection of level VEGF for diagnosing renal damage early of pregnant women with GDM were72.4%,72.3%,79.4%,0.617(95% CI:0.729-0.931),respectively,and the sensitivity,specificity,accuracy,and area under the curve(AUC)of detection of FABP4 level for diagnosing renal damage early of pregnant women with GDM were 79.4%、72.8%、81.8%、0.729(95%CI:0.617-0.872),respectively.And the sensitivity,specificity,accuracy,and area under the curve(AUC)of detection of level VEGF combined with detection of FABP4 level for diagnosing renal damage early of pregnant women with GDM were 89.4%,82.8%,83.8%,and 0.894(95%CI:0.829-0.941),respectively.Conclusion:Serum levels of VEGF and FABP4 in peripheral blood of pregnant women with GDM and renal damage early may increase significantly,so the detection of serum VEGF and FABP4 levels can help to diagnose renal damage early of pregnant women with GDM,which can provide evidence for clinical diagnosis and treatment.

引文

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