Abstract: ［Abstract］Objective〖HTSS〗To observe the clinical value of urinary semakin 3A(Sema 3A), renal injury molecule 1(KIM-1) and serum cystatin C(Cys C) in the early diagnosis of renal function impairment in patients with pre-eclampsia(PE).
〖HTH〗〖WTHZ〗Methods〖HTSS〗One hundred and sixteen patients with PE were divided into mild PE group(49 cases) and severe PE group(67 cases). Sixty pregnant women undergoing physical examination in our hospital at the same period were selected as the control group. The changes of Sema 3A, KIM-1, and Cys C levels were observed in three groups, the correlation among Sema 3A, KIM-1, and Cys C levels were observed in patients with preeclampsia and those levels which related with renal impairment were also observed, as well as the early diagnostic value of combined Sema 3A, KIM-1 and Cys C detection for renal dysfunction was explored.
〖HTH〗〖WTHZ〗Results〖HTSS〗The levels of 24 h urine protein, serum creatinine, blood urea nitrogen, uric acid in mild PE group and severe PE group were significantly higher than those in control group, and the glomerular filtration rate was significantly lower than that in control group; the 24-hour urine protein and uric acid levels in severe PE group were significantly higher than those in mild PE group, and the glomerular filtration rate was significantly lower than that in mild PE group(P＜0.05). The levels of urine Sema 3A, KIM-1 and serum Cys C in mild PE group and severe PE group were significantly higher than those in control group, the levels of those in severe PE group were significantly higher than those in mild PE group(P＜0.05). The level of urine Sema 3A in PE patients was positively correlated with urine KIM-1 and serum Cys C, and urine KIM-1 was positively correlated with serum Cys C(P＜0.05). Urine Sema 3A, KIM-1 and serum Cys C levels in renal dysfunction group were significantly 〖JP2〗higher than thosein normal renal function group(P＜0.05). The Sema 3A, KIM-1, Cys C levels and combined detection(Sema 3A+〖JP〗KIM-1+Cys C) were used as test variables, and the receiver operating characteristic curve was plotted with renal impairment as a state variable. The best cut-off value of combined detection for diagnosis of early renal dysfunction was >0.258, sensitivity was 72.5%, specificity was 93.8%, and area under curve of 0.890 which was significantly better than Sema 3A, KIM-1 and Cys C(P＜0.05), there was no significant difference in the area under the curve between Sema 3A, KIM-1 and Cys C(P＞0.05).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗Sema 3A, KIM-1 and Cys C are involved in the development of pregnancy with eclampsia and renal impairment. It has important clinical value that combination detection of ema 3A, KIM-1 and Cys C markers in eclampsia can predict early renal impairment.

Key words: eclampsia； renal insufficiency； semaphorin-3A, renal injury molecule 1, cystatin C