中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
12期
1287-1290
,共4页
李绍梅%薛雯%温文龙%张丽萍%张春霞%闫喆%段建召
李紹梅%薛雯%溫文龍%張麗萍%張春霞%閆喆%段建召
리소매%설문%온문룡%장려평%장춘하%염철%단건소
原发性肾病综合征%急性肾小管坏死%中性粒细胞明胶酶相关脂质运载蛋白%肾损伤因子1
原髮性腎病綜閤徵%急性腎小管壞死%中性粒細胞明膠酶相關脂質運載蛋白%腎損傷因子1
원발성신병종합정%급성신소관배사%중성립세포명효매상관지질운재단백%신손상인자1
Primary nephrotic syndrome%Acute tubular necrosis%Neutrophil gelatinase associated lipocalin%Kidney injury molecule-1
目的 探讨原发性肾病综合征(PNS)患者尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和肾损伤因子1(KIM-1)浓度变化在肾病综合征合并急性肾损伤中的作用及意义.方法 72例PNS患者包括肾小球微小病变(MCD)34例、膜性肾病(MN)23例和系膜增生肾炎(MsPGN)15例,根据肾脏病理改变分为PNS合并急性肾小管坏死(ATN)组15例和无ATN组57例,选取15名尿检正常的健康体检者作为对照组.采用酶联免疫吸附试验(ELISA)检测尿NGAL及KIM-1浓度,分析其与PNS病理类型、合并ATN时的变化及与临床指标的关系.结果 MCD、MN、MsPGN组和对照组尿NGAL浓度分别为(46.81±15.75)、(22.09±7.69)、(15.31±3.74)、(8.03±0.35) μg/L,MCD、MN、MsPGN组均高于对照组(P均＜0.05),MCD组显著高于MN组和MsPGN组(P均＜0.05);MCD、MN、MsPGN组和对照组尿KIM-1浓度分别为(2.41±0.58)、(2.54±0.67)、(2.87±0.50)、(0.73±0.35)μg/L,MCD、MN、MsPGN组均高于对照组(P均＜0.05),但MCD、MN、MsPGN组间差异无统计学意义(P＞0.05).PNS患者尿NGAL和KIM-1浓度分别为(42.37±28.24) μg/L与(2.76±1.11) μg/L,明显高于对照组(t值分别为4.668、12.665,P均＜0.01).PNS合并ATN组尿NGAL浓度[(74.98±9.52) μg/L]和KIM-1浓度[(3.60±0.92) μg/L]明显高于PNS未合并ATN组[尿NGAL (31.31±2.34) μg/L,KIM-1(2.54±0.81) μg/L](P均＜0.05).相关分析显示尿NGAL和KIM-1与尿β2微球蛋白(β2-MG)、血肌酐、尿素氮、24h尿蛋白呈正相关(r值分别为0.432、0.299、0.234、0.254,0.434、0.650、0.276、0.301,P均＜0.05).结论 尿NGAL和尿KIM-1可作为反映PNS合并ATN的早期、无创的生物学指标.
目的 探討原髮性腎病綜閤徵(PNS)患者尿中性粒細胞明膠酶相關脂質運載蛋白(NGAL)和腎損傷因子1(KIM-1)濃度變化在腎病綜閤徵閤併急性腎損傷中的作用及意義.方法 72例PNS患者包括腎小毬微小病變(MCD)34例、膜性腎病(MN)23例和繫膜增生腎炎(MsPGN)15例,根據腎髒病理改變分為PNS閤併急性腎小管壞死(ATN)組15例和無ATN組57例,選取15名尿檢正常的健康體檢者作為對照組.採用酶聯免疫吸附試驗(ELISA)檢測尿NGAL及KIM-1濃度,分析其與PNS病理類型、閤併ATN時的變化及與臨床指標的關繫.結果 MCD、MN、MsPGN組和對照組尿NGAL濃度分彆為(46.81±15.75)、(22.09±7.69)、(15.31±3.74)、(8.03±0.35) μg/L,MCD、MN、MsPGN組均高于對照組(P均＜0.05),MCD組顯著高于MN組和MsPGN組(P均＜0.05);MCD、MN、MsPGN組和對照組尿KIM-1濃度分彆為(2.41±0.58)、(2.54±0.67)、(2.87±0.50)、(0.73±0.35)μg/L,MCD、MN、MsPGN組均高于對照組(P均＜0.05),但MCD、MN、MsPGN組間差異無統計學意義(P＞0.05).PNS患者尿NGAL和KIM-1濃度分彆為(42.37±28.24) μg/L與(2.76±1.11) μg/L,明顯高于對照組(t值分彆為4.668、12.665,P均＜0.01).PNS閤併ATN組尿NGAL濃度[(74.98±9.52) μg/L]和KIM-1濃度[(3.60±0.92) μg/L]明顯高于PNS未閤併ATN組[尿NGAL (31.31±2.34) μg/L,KIM-1(2.54±0.81) μg/L](P均＜0.05).相關分析顯示尿NGAL和KIM-1與尿β2微毬蛋白(β2-MG)、血肌酐、尿素氮、24h尿蛋白呈正相關(r值分彆為0.432、0.299、0.234、0.254,0.434、0.650、0.276、0.301,P均＜0.05).結論 尿NGAL和尿KIM-1可作為反映PNS閤併ATN的早期、無創的生物學指標.
목적 탐토원발성신병종합정(PNS)환자뇨중성립세포명효매상관지질운재단백(NGAL)화신손상인자1(KIM-1)농도변화재신병종합정합병급성신손상중적작용급의의.방법 72례PNS환자포괄신소구미소병변(MCD)34례、막성신병(MN)23례화계막증생신염(MsPGN)15례,근거신장병리개변분위PNS합병급성신소관배사(ATN)조15례화무ATN조57례,선취15명뇨검정상적건강체검자작위대조조.채용매련면역흡부시험(ELISA)검측뇨NGAL급KIM-1농도,분석기여PNS병리류형、합병ATN시적변화급여림상지표적관계.결과 MCD、MN、MsPGN조화대조조뇨NGAL농도분별위(46.81±15.75)、(22.09±7.69)、(15.31±3.74)、(8.03±0.35) μg/L,MCD、MN、MsPGN조균고우대조조(P균＜0.05),MCD조현저고우MN조화MsPGN조(P균＜0.05);MCD、MN、MsPGN조화대조조뇨KIM-1농도분별위(2.41±0.58)、(2.54±0.67)、(2.87±0.50)、(0.73±0.35)μg/L,MCD、MN、MsPGN조균고우대조조(P균＜0.05),단MCD、MN、MsPGN조간차이무통계학의의(P＞0.05).PNS환자뇨NGAL화KIM-1농도분별위(42.37±28.24) μg/L여(2.76±1.11) μg/L,명현고우대조조(t치분별위4.668、12.665,P균＜0.01).PNS합병ATN조뇨NGAL농도[(74.98±9.52) μg/L]화KIM-1농도[(3.60±0.92) μg/L]명현고우PNS미합병ATN조[뇨NGAL (31.31±2.34) μg/L,KIM-1(2.54±0.81) μg/L](P균＜0.05).상관분석현시뇨NGAL화KIM-1여뇨β2미구단백(β2-MG)、혈기항、뇨소담、24h뇨단백정정상관(r치분별위0.432、0.299、0.234、0.254,0.434、0.650、0.276、0.301,P균＜0.05).결론 뇨NGAL화뇨KIM-1가작위반영PNS합병ATN적조기、무창적생물학지표.
Objective To investigate the significance of neutrophil gelatinase associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in the patients of primary nephmpathy syndrome (PNS) complicated with acute kidney injury (AKI) by detecting urinary level of NGAL and KIM-1.Methods Senventy-two patients of PNS were selected as our subjects including 34 case with minimal change disease (MCD),23 cases with membranous nephropathy(MN),15 cases with mesangial proliferative glomerulonephritis (MsPGN).Fifteen cases of healthy physical examination were selected as control group.Meanwhile subjects were also divided into PNS with ATN group (15 cases) and PNS without ATN group (57 cases) according to their pathology check.ELISA was applied to detect the urinary level of NGAL and KIM-1,whose correlation with pathological type and clinical index were analyzed.Results The urinary level of NGAL and KIM-1 in patients with PNS were (42.37 ± 28.24) μg/L,(2.76 ± 1.11) μg/L respectively,higher than that of control group (P ＜0.01).The urinary level of NGAL in the MCD group,MN group,MsPGN group were higher than that of control group (46.81 ± 15.75) μg/L,(22.09 ± 7.69) μg/L,(15.31 ± 3.74) μg/L,(8.03 ± 0.35) μg/L respectively,P ＜ 0.05).The urinary level of NGAL in MCD group was significantly highest than that in the other groups (P ＜ 0.05).The urinary level of KIM-1 in the MCD group,MN group,MsPGN group were higher than that of control group(2.41 ±0.58) μg/L,(2.54 ±0.67) μg/L,(2.87 ±0.50) μg/L,(0.73 ±0.35) μg/L respectively,P ＜0.05).But there was no significant difference among MCD,MN,MsPGN groups(P ＞ 0.05).The urinary level of NGAL and KIM-1 in patients PNS were (42.37 ± 28.34) μg/L and (2.76 ± 1.11) μg/L,significantly higher than that of control group (t =4.668,12.665,P ＜ 0.05).The urinary level of NGAL and KIM-1 in patients PNS with ATN were significantly higher than patient without ATN (NGAL:(74.98 ±9.52) μg/L vs.(31.31 ±2.34) μg/L;KIM-1:(3.60 ±0.92) μg/L vs.(2.54 ±0.81) μg/L,P ＜0.05).The correlation analysis showed that the urinary level of NGAL and KIM-1 was positively correlated with serum β2-MG,serum creatinine,serum blood urea nitrogen and 24-hour urine protein.(r =0.432,0.299,0.234,0.254,0.434,0.650,0.276,0.301 respectively,P ＜ 0.05).Conclusion The urinary level of NGAL and KIM-1 could be considered as the early,non-invasive biologic factors to reflect in patients of PNS with ATN.
