Abstract:

Objective To evaluate the role of serum angiotensin-converting enzyme（ACE） in the early diagnosis of pregnancy-induced hypertension. Methods A total of 55 pregnant women with pregnancy-induced hypertension and 45 healthy pregnant women（control group） were enrolled. Renal function indices [creatinine（Cr）,blood urea nitrogen（BUN）,uric acid（UA）,cystatin C（Cys C）,retinol-binding protein（RBP） and beta₂-microglobulin（β₂-MG） levels],glucose（Glu）and ACE level were determined at the middle- and later-periods of pregnancy. Receiver operating characteristic（ROC） curve was used to evaluate the roles of renal function indices and ACE level for the diagnosis of pregnancy-induced hypertension. Results The levels of Cr,BUN,UA,Cys C and RBP in pregnancy-induced hypertension group at the middle-period of pregnancy were higher than those in control group（P<0.05）. The levels of Cr,UA,Glu,β₂-MG,RBP and ACE at the later-period of pregnancy were higher than those in control group（P<0.05）. The levels of BUN,β₂-MG,RBP and ACE in pregnancy-induced hypertension group at the later-period of pregnancy were higher than those at the middle-period of pregnancy（P<0.05）,and the other indices had no statistical significance（P>0.05）. ROC curve showed that the area under curve（AUC） of Cr（0.716） was the biggest at the middle-period of pregnancy. At the later-period of pregnancy,the AUC of ACE（0.924） was the biggest,followed by the AUC of β₂-MG（0.897）. From the middle-period of pregnancy to later-period of pregnancy,ACE had the most obvious increasing of AUC. The sensitivities of β₂-MG for the diagnosis of pregnancy-induced hypertension were increased from 63.6% at the middle-period of pregnancy to 67.3% at the later-period of pregnancy,and the specificities were increased from 55.6% to 88.9%. The sensitivities of ACE were increased from 70.9% to 83.6%,and the specificities were increased from 95.6% to 97.8 %. There was no correlation between β₂-MG and ACE（r=0.278,P>0.05）. Conclusions ACE is a sensitive index for the early diagnosis of pregnancy-induced hypertension.

Key words: Angiotensin-converting enzyme, Renal function, Diagnosis, Pregnancy-induced hypertension