NGAL在慢性肾炎肾损伤患者中的应用价值

摘要

Objective To detect the level of serum and urinary Neutrophil gelatinase- associated lipocalin (NGAL) in patients with chronic nephritis and assess the value of NGAL in early diagnosis of renal damage. Methods Two copy of serum and urine samples were collected in two week from 80 patients with chronic nephritis and 40 healthy controls from Yijishan Hospital of Wannan Medical College. NGAL concentration was assayed using Latex agglutination method. Serum creatinene (Cr),blood urea nitrogen (BUN) ,Cystatin-C (CysC),and 24h urine protein (24-UPro) were detected using routine method. Results The concentration of serum NGAL in patients with chronic nephritis and controls were 444. 4 ± 399. 1 ng/ml and 63. 6 ± 35. 8 ng/ml respectively, with a statistical P value less than 0. 001. The level of urine NGAL in patients with chronic nephritis and controls were 374.4 ± 326.3 ng/ml and 42.6 ± 17.7 ng/ml, with P value less than 0.001. Serum NGAL concentration was positively correlated with U-NGAL, Cr, Cys-c, BUN and 24-Upro (r value was 0.535,0.372, 0. 338 ,0. 382 , respectively, P< 0. 05 ). Patients were assigned to three groups according to serum NGAL concentration (group A<200 ng/ml,group B between 200 and 500 ng/ml,group C>500 ng/ml). The increase of level of urine NGAL,serum Cysc,serum Cr,serum BUN and UPro were more in the C group than in the other groups between the two copy of samples. Conclusion The level of serum NGAL could be a useful indicator for evaluating the chronic renal damage.%目的 检测并分析中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)与慢性肾炎肾功能指标的关联性,评价其在肾炎患者慢性肾损伤中的应用.方法 留取2012年1月～2013年2月皖南医学院弋矶山医院80例慢性肾炎住院患者和40例健康体检者血清和尿液标本,两周后再留取一份,采用胶乳凝集法检测样本中NGAL的浓度;常规生化检测血清样本中肌酐(creatinine,Cr)、尿素(BUN)、胱抑素-C(Cystatin-C,CysC)以及24h尿蛋白定量(24-Upro)的水平.结果 血清中NGAL在慢性肾炎组和健康对照组中的水平分别为444.4±399.1 ng/ml和63.6±35.8 ng/ml,差异有统计学意义(t=3.427,P<0.001);尿中NGAL在慢性肾炎组和健康对照组中的水平分别为374.4±326.3 ng/ml和42.6±17.7 ng/ml,差异有统计学意义(t=3.582,P<0.001).血清NGAL与尿NGAL,Cr,BUN和24-Upro呈正相关(相关系数r分别为0.535,0.372,0.338和0.382,P<0.05).慢性肾炎患者按血清NGAL浓度分为三组,即<200 ng/ml为A组,200～500 ng/ml为B组,>500 ng/ml为C组,其中,C组患者尿NGAL水平以及血清中Cr,Cys-C,BUN和24-Upro的水平前后均显著升高(t=2.238～2.519,P<0.05),A组患者仅尿NGAL水平前后显著升高(P<0.05),B组患者血Cr和24-Upro水平前后显著升高(t=2.015-2.476,P<0.05).结论 NGAL的水平在慢性肾炎患者血清和尿液中的水平都升高,可作为慢性肾炎肾功能减退的早期指标.