Abstract Objective To explore the clinical value of combined detection of cystatin-C(Cys-C),neutrophil gelatinaseassociated lipocalin(NGAL)and kidney injury molecule-1(KIM-1)in patients with pregnancy-induced hypertension and nephropathy.Methods A total of 180 patients with pregnancy-induced hypertension who were admitted to Bao′an Central Hospital of Shenzhen City from February 2018 to August 2020 were randomly selected as the research subjects,based on the urine albumin/creatinine ratio(uACR),the patients were divided into simple pregnancy-induced hypertension group(group A,uACR<30 mg/g,90 cases),early pregnancy-induced hypertension syndrome combined with acute kidney injury group(group B,30 mg/g≤uACR<300 mg/g,50 cases),clinical pregnancy-induced hypertension nephropathy group(group C,ACR≥300 mg/g,40 cases),and 100 normal pregnant women were selected as the control group during the same period.The dynamic changes of serum NGAL,KIM-1 and Cys-C concentrations in each group were compared,the correlation between serum NGAL,KIM-1,Cys-C levels and uACR was analyzed,and the receiver operating characteristic(ROC)curve was used to analyze each various indicators to determine the efficacy of early renal injury in patients with pregnancy-induced hypertension.Results The serum NGAL,KIM-1 and Cys-C levels of the group A,the group B and the group C were higher than those of the control group,and the group C>the group B>the group A,the differences were statistically significant(P <0.05).According to Spearman correlation analysis,serum NGAL,KIM-1,Cys-C levels of patients in group B and C were positively correlated with uACR(r=0.651,0.673,0.563, P<0.05).ROC curve analysis showed that the AUCs of NGAL,KIM-1,Cys-C and the combined test of the three to diagnose early renal injury in patients with pregnancy-induced hypertension were 0.754(95%CI:0.685-0.908),0.804(95%CI:0.689-0.913),0.763(95%CI:0.683-0.907)and 0.923(95%CI:0.858-0.998);the best cut-off values for NGAL,KIM-1,and Cys-C were 44.5 ng/mL,37.8 ng/L and 1.3 mg/L,respectively,the sensitivity of NGAL,KIM-1,Cys-C and the combination of the three was 74.57%,81.25%,73.01% and 95.61%,respectively,and the specificity of NGAL,KIM-1,Cys-C and the combination of the three was 76.03%,72.34%,82.24% and 98.64%,respectively.Conclusion Serum NGAL,KIM-1 and Cys-C levels are significantly positively correlated with the degree of renal impairment in patients with pregnancy-induced hypertension.The combined detection of NGAL,KIM-1 and Cys-C has good clinical diagnostic value in predicting the diagnostic efficacy of acute kidney injury in pregnancy-induced hypertension syndrome.
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