糖尿病肾病患者尿液NGAL和IL-18的改变及其临床意义

摘要

Objective: To investigate the roles of urinary NGAL and IL-18 in patients with diabetic nephropathy. Methods: Eighty patients with type 2 diabetes mellitus ( T2DM) were categorized into three groups ; normoal-buminuria, microalbuminuria and macroalbuminuria groups. Twenty -live healthy subjects were recruited as controls. The urine NGAL and IL-18 were measured using ELISA. The correlations between ACR/Cr and NGAL/Cr or IL48/Cr in urine were analyzed. Results:Both urine NGAL/Cr and IL48/Cr were significantly increased in patients of diabetic nephropathy with respect to controls ( P < 0. 05 ) , and reached peak in patients with macroalbu -minuria, which was consistent with the impairment of renal function . Both NGAL/Cr and IL48/Cr were positively correlated with ACR/Cr in urine of patients. Conclusions: NGAL and IL-18 may play important roles in the development of DN , suggesting probable novel predictors of the severity of DN .%目的:探讨糖尿病肾病(DN)患者尿液中性粒细胞明胶酶相关载脂蛋白(NGAL)、IL-18的改变及其临床意义.方法:选择2型糖尿病(T2DM)患者80例(糖尿病组),其中正常白蛋白尿(NA)组31例、微量白蛋白尿(MI)组26例、大量白蛋白尿(MA)组23例;正常对照组25例.应用ELISA法检测尿液NGAL、IL-18的浓度.并分别分析尿NGAL/尿肌酐(Cr)及尿 IL-18/尿Cr与尿白蛋白/Cr比值(ACR)/尿Cr之间的相关关系.结果:T2DM患者尿 NGAL/尿Cr和尿IL-18/尿Cr均较对照组显著升高(P均<0.05),其中MA组患者的尿 NGAL/尿Cr和尿 IL-18/尿Cr最高,与肾损害的严重程度一致.T2DM患者尿NGAL/尿 Cr和尿 IL-18/尿 Cr的水平均与ACR/尿Cr存在正相关,且尿 NGAL/尿Cr与ACR/尿 Cr的相关性更密切.结论:NGAL、IL-18可能参与了DN的形成与发展,NGAL、IL-18有望成为评价DN肾损害程度的指标之一.