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Abstract Objective: To investigate the diagnostic value of detection of serum β2-microglobulin (β2-MG) combined with detection of retinolbinding protein 4 (RBP4) and urine neutrophil gelatinaseassociated lipocalin (NGAL) for early renal impairment of patients with hypertensive disorder complicating pregnancy (HDCP). Methods: 63 patients with HDCP were selected in observation group, and another 42 normal pregnant women were selected in control group. Based on the urinary protein excretion rate (UAER), the patients in observation group were also divided into normal proteinuria group (16 cases, UAER<20 ug/min), and microalbumin (23 patients, 20 ug/min<UAER<200 ug/min), and massive proteinuria group (24 patients, UAER>200 ug/min). The levels of serum β2-MG, RBP4, and urinary NGAL of patients were measured in each group. Differences among these groups was analyzed, and receiver operating characteristic curve (ROC) analysis of β2-MG detection combined with detection of RBP4 and NGAL was used to evaluated the value for early diagnosing renal damage of patients with HDCP. Results: The serum levels of β2-MG, RBP4 and urinary NGAL of patients in massive proteinuria group were significant higher than those of patients in microal buminuria group, those of patients in microal buminuria group were significant higher than those of patients in normal proteinuria group, and those of patients in normal proteinuria group were significant higher than those of patients in healthy control group (all P<0.05). The positive rates by combined detection in normal proteinuria group, in microproteinuria group, and in macroalbuminuria group were 31.3%, 95.7%, and 100%, respectively, which were significant higher than those by individual detection. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and positive likelihood ratio by combined detection for diagnosing early renal injury of patients with HDCP were 89.4%, 92.8%, 90.3%, 93.0%, 93.8%, and 9.0, respectively, which were significant higher than those detected by individual detection, but the negative likelihood ratio of combined detection (1.02) was significant lower than that by individual detection. The area under the curve (AUC) of β2-MG, RBP4, NGAL, and combined detection by ROC analysis for diagnosing early renal injury of patients with HDCP was 0.64 (95% CI: 0.03-1.38), 0.73 (95% CI: 0.64-9.03), 0.80(95% CI: 0.03-13.06, and 0.90 (95% CI: 0.03-6.31). Conclusion: The serum β2-MG detection combines with detection of RBP4 and urinary NGAL can improve the accuracy of diagnosis early renal injury of patients with HDCP, which can provide a reliable evidence for clinical diagnosis and treatment.
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