CAJ | 학술논문

目的：分析原发性局灶节段硬化性肾小球肾炎（ FSGS）患者血浆置换治疗前后尿液中性粒细胞明胶酶相关载脂蛋白（ NGAL）变化的临床意义。方法观察2012年1～12月石家庄肾病医院肾五科经肾活检诊断为FSGS的患者105例，比较血浆置换治疗前、治疗后1周、4周尿液NGAL的差异及同期24 h尿蛋白定量结果。结果治疗1周后与血浆置换治疗前比较，尿 NGAL 显著下降[（7.2±1.5）μg 比（10.2±2.3）μg，P ＜0.05]，但24 h 蛋白定量差异无统计学意义[（2920±1690） mg 比（3070±1810） mg， P ＞0.05]；治疗4周后较血浆置换治疗前，尿 NGAL 显著下降[（6.2±2.1）μg比（10.2±2.3）μg，P＜0.05]，且24 h尿蛋白定量也显著下降[（1430±180） mg 比（3070±1810） mg，P＜0.05]；血浆置换治疗后4周与治疗后1周比较，尿 NGAL结果差异无统计学意义[（6.2±2.1）μg比（7.2±1.5）μg，P＞0.05]，而24 h尿蛋白定量显著下降[（1430±180） mg比（2920±1690） mg，P＜0.05]。结论尿液NGAL测定与临床疗效具有一致性，其敏感程度较24 h尿蛋白定量高。
목적：분석원발성국조절단경화성신소구신염（ FSGS）환자혈장치환치료전후뇨액중성립세포명효매상관재지단백（ NGAL）변화적림상의의。방법관찰2012년1～12월석가장신병의원신오과경신활검진단위FSGS적환자105례，비교혈장치환치료전、치료후1주、4주뇨액NGAL적차이급동기24 h뇨단백정량결과。결과치료1주후여혈장치환치료전비교，뇨 NGAL 현저하강[（7.2±1.5）μg 비（10.2±2.3）μg，P ＜0.05]，단24 h 단백정량차이무통계학의의[（2920±1690） mg 비（3070±1810） mg， P ＞0.05]；치료4주후교혈장치환치료전，뇨 NGAL 현저하강[（6.2±2.1）μg비（10.2±2.3）μg，P＜0.05]，차24 h뇨단백정량야현저하강[（1430±180） mg 비（3070±1810） mg，P＜0.05]；혈장치환치료후4주여치료후1주비교，뇨 NGAL결과차이무통계학의의[（6.2±2.1）μg비（7.2±1.5）μg，P＞0.05]，이24 h뇨단백정량현저하강[（1430±180） mg비（2920±1690） mg，P＜0.05]。결론뇨액NGAL측정여림상료효구유일치성，기민감정도교24 h뇨단백정량고。
Objective To analyze the change of urinary neutrophil gelatinase-associated lipocalin (NGAL) level in patients with primary focal segmental glomerulosclerosis(FSGS) before and after plasma exchange and find out the clinical significance .Methods A total of 105 FSGS patients confirmed with biopsy in Department Five of Nephrology,Shijiazhuang Kidney Disease Hospital from January to December 2012 who underwent plasma exchange were enrolled in the study.Urine NGAL was assessed at baseline, 1 week and 4 weeks after plasma exchange treatment, and compared with the quantitative test of 24 h urinary protein tested at the same time.Results After 1 week of plasma exchange treatment,the urine NGAL level was significant-ly decreased, compared with baseline[(7.2 ±1.5) μg vs (10.2 ±2.3) μg ,P<0.05], but the quantita-tive test of 24 h urinary protein had no statistical change[(2920 ±1690) mg vs(3070 ±1810) mg,P >0.05].Both of urine NGAL level[(6.2 ±2.1) μg vs (10.2 ±2.3) μg,P<0.05] and quantitative test of 24 h urinary protein[(1430 ±180) mg vs(3070 ±1810) mg,P<0.05] were significantly decreased after 4 weeks compared with baseline.Comparing the results of 4 weeks with 1 week after treatment, urine NGAL level had no statistically significant decrease[(6.2 ±2.1) μg vs (7.2 ±1.5) μg,P >0.05], while the quantitative test of 24 h urinary protein was dramatically decreased [ ( 1430 ±180 ) mg vs ( 2920 ±1690 ) mg,P<0.05].Conclusion Urine NGAL test is consistent with clinical efficacy,and its sensitivity is higher than 24 h urinary protein quantity test.