doi:l0.3969/j.issn.1673-5013.2017.04.005NT-ProBNP测定在妊娠糖尿病肾损伤中变化及临床诊断伽直李艳丽(郑州市妇幼保健院检验科，河南郑州450000)[摘要]目的：探讨氨基末端B型利钠肽前体(NT-ProBNP)在妊娠糖尿病肾损伤患者中的变化及其临床诊断价值。方法：选取妊娠性糖尿病患者(GDM组)75例，健康妊娠孕妇(健康对照组)55例，根据尿白蛋白排泄率(UAER),依照Mogensen分期将GDM患者分为单纯GDM组、早期肾病组及临床肾病组，分别检测各组血清NT-ProBNP、胱抑素C(CysC)、肌肝(Cr)及尿微量白蛋白(mALB)水平，并对结果进行分析，同时用Pearson相关分析分析NT-ProBNP与CysC、Cr及mALB的向相关性。结果：结果显示GDM组血清NT-ProBNP、CysC、Cr及mALB水平显著高于健康对照组(P<0.05),并且NT-ProBNP从单纯GDM组、早期肾病组及临床肾病组逐渐升高，差异具有统计学意义(PV0.05)。Pearson相关性分析显示，NT-ProBNP与CysC、Cr及mALB成正相关(PV0.05)。结论：NT-ProBNPi妊娠糖尿病患者血清明显升高，与其微血管病变有关，可作为诊断妊娠糖尿病肾病和评估其肾脏损伤程度的指标。.[关键词]氨基末端B型利钠肽前体；妊娠糖尿病；肾损伤ChangeofNT-ProBNPdetectioningestationaldiabetesmellituswithrenalinjuryanditsclinicaldiagnosevalueLIYan-li(MedicialLaboratoryCenter,ZhengzhouMaternalandChildHeahhHospital,HenanZhengzhou450000)[Abstract]Objective：ToobservethechangeofN—terminalpro—brainnatriureticpeptidelevelsingestationaldiabetesmellitusandtoinvestigateitsclinicalsignificanceinpatientswithgestationaldiabetesmellitus.Methods：60caseswithgestationaldiabetesmellitus(GDM)and40normalpregnantwomen(healthcontrolgroup)wereenrolled.Accordingtotheurinaryalbuminexcretionrace(UAER),GDMpatientsweredividedintopureGDMgroup,theearlynephropathygroupandclinicalkidneydiseasegroupinaccordancewithMogensenstaging.SuremHE,NT—ProBNP,CysC,Crandurinetracealbumin(mALB)levelsindifferentgroupsweretested,andtheresultswereanalyzed.Atthesamerime,thecorrelationsofN—terminalpro—brainnatriureticpepridewithCysC,Crandurinetracealbumin(mALB)wereanalyzedbyPearsoncorrelarionanalysis.Results：ThelevelsofNT—ProBNP,CysC,CrandurinemALBweresignificandyhigherinGDMpatientsthanthoseinhealthycontrols(P<0.05).TheresultsshowedthatN—terminalpro—brainnatriureticpepridelevelsinpureGDMgroup,theearlynephropathygroupandclinicalkidneydiseasegroupweregraduallyincreased,thedifferenceisstatisticallysignificant(P<0.05).PearsoncorrelationanalysisrevealedthatN一terminalpro—brainnatriureticpepridewaspositivelycorrelatedwithCysC,Crandurinetracealbumin(mALB)(allP<0.05).Conclusion：ThelevelofNT—ProBNPincreasedsignificandyinpatientswithgestationaldiabetesmellitus.NT-ProBNPmaycorrelatewithdiabeticmicroangiopathy,whichcanbeusedasreliableclinicalmarkerforassessingtheseverityanddiagnosisofdiabeticnephropathy.[Keywords]N—terminalpro—brainnatriureticpeptide;Gestationaldiabetesmellitus;Renalinjury妊娠糖尿病(GDM)是指妊娠期发生的糖耐量异常,而肾损害作为妊娠期糖尿病的严重并发症之一叫对患者肾功能造成严重影响，因此早期诊断并积极干预是改变患者预后的关键。氨基末端B型利钠肽前体(NT-ProBNP)可能是预测慢性肾脏疾病的新标志物％CysC是反映是评价糖尿病肾损伤可靠、敏感的内源性指标本，本研究主要检测血清NT-ProBNP在妊娠性糖尿病患者中的变化，并与CysC等指标进行相关性分析，来探讨血清NT-ProBNP对妊娠糖尿病肾损伤诊断的临床价值。1材料和方法1.1一般材料选取2015年4月~2016年12月我院产科收治确诊为GDM患者75例，患者年龄跨度为23~38岁,平均(28.4±5.2)岁，孕周为26~40周，根据尿白蛋白排泄率(UAER),按Mogensen分期法患者分为三组：单纯GDM组(UAER<30mg/24h)32例、早期肾病组(UAER30~300mg/24h...