慢性肾病患者尿液KIM-1和NGAL表达水平与肠道免疫屏障功能的相关性  

Correlation between urinary KIM-1 and NGAL expression and intestinal immune barrier function in patients with chronic kidney disease

作　　者：杨晶 柳彩侠 李璐 邱晓楠 YANG Jing;LIU Cai⁃xia;LI Lu;QIU Xiao⁃nan(Laboratory of Nephrology,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;Department of Nephrology,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州医科大学附属医院肾内科实验室,江苏徐州221000 [2]徐州医科大学附属医院肾内科,江苏徐州221000

出　　处：《热带医学杂志》2022年第12期1680-1683,1705,共5页Journal of Tropical Medicine

基　　金：江苏省第十四批“六大人才高峰”高层次人才选拔培养资助方案(创新人才团队项目)(WSN-113)

摘　　要：目的探究慢性肾病(CKD)患者尿液肾损伤分子1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)表达与肠道免疫屏障功能的相关性。方法2020年1月-2022年1月在徐州医科大学附属医院进行治疗的157例CKD患者为研究对象(CKD组),另选取85名健康体检者为对照组。收集受试者临床指标,采用酶联免疫吸附法(ELISA)检测尿液KIM-1、NGAL、粪便分泌型免疫球蛋白A(sIgA)水平,采用鲎试验三肽基质显色法检测血浆内毒素水平,采用改良的酶学分光光度法检测D-乳酸水平。Pearson相关性分析KIM-1与NGAL的关系以及二者与肠道免疫屏障功能指标、一般临床资料的相关性。结果CKD组与对照组白蛋白(Alb)、血磷、血肌酐(SCr)、血胱抑素C、血尿素氮(BUN)、大肠杆菌水平比较差异均有统计学意义(P均<0.05)。CKD组患者KIM-1、NGAL表达水平、内毒素、D-乳酸水平分别为(126.82±22.52)ng/L、(146.78±29.87)μg/L、(239.76±41.63)EU/mL、(3.52±0.33)mmol/L,高于对照组的(56.24±7.14)ng/L、(31.05±6.23)μg/L、(127.54±26.18)EU/mL、(2.43±0.28)mmol/L;sIgA含量(9.17±1.84)μg/mL,低于对照组的(14.33±2.75)μg/mL,差异均有统计学意义(P均<0.05)。Pearson相关性分析结果表明,KIM-1与NGAL成正相关(r=0.583,P<0.05);KIM-1、NGAL水平与内毒素、D-乳酸、血磷、SCr、血胱抑素C、BUN、大肠杆菌水平成正相关,与sIgA、Alb含量成负相关(P均<0.05)。结论CKD患者尿液KIM-1、NGAL水平显著上调,且二者水平与肠道免疫屏障功能密切相关。Objective To explore the correlation between the urinary kidney injury molecule-1(KIM-1),neutrophil gelatinase-associated lipocalin(NGAL)expression and intestinal immune barrier function in patients with chronic kidney disease(CKD).Methods A total of 157 CKD patients who were treated in the Affiliated Hospital of Xuzhou Medical University from January 2020 to January 2022 were collected as the research objects,as the CKD group,and 85 healthy subjects were collected as the control group.Urine KIM-1,NGAL and fecal secretory immunoglobulin A(sIgA)levels were detected by enzyme-linked immunosorbent assay(ELISA);plasma endotoxin level was detected by the Limulus test tripeptide matrix chromogenic method;D-lactate acid level was detected using a modified enzymatic spectrophotometric method,and the relationship between KIM-1 and NGAL,and their correlation with intestinal immune barrier function indexes and general clinical data were analyzed by Pearson correlation analysis.Results The levels of albumin(Alb),serum phosphorus,serum creatinine(SCr),cystatin C,blood urea nitrogen(BUN)and Escherichia coli were obviously different between the CKD group and the control group(P all<0.05).The expression levels of KIM-1,NGAL,and the levels of endotoxin and D-lactic acid in the CKD group were(126.82±22.52)ng/L,(146.78±29.87)μg/L,(239.76±41.63)EU/mL and(3.52±0.33)mmol/L,respectively,which were higher than those in the control group[(56.24±7.14)ng/L,(31.05±6.23)μg/L,(127.54±26.18)EU/mL,(2.43±0.28)mmol/L],and the content of sIgA was(9.17±1.84)μg/L,which was lower than that in the control group[(14.33±2.75)μg/mL](P all<0.05).The results of Pearson correlation analysis showed that KIM-1 was positively correlated with NGAL(r=0.583,P<0.05).The levels of KIM-1 and NGAL were obviously positively correlated with the levels of endotoxin,D-lactic acid,serum phosphorus,SCr,cystatin C,BUN and Escherichia coli,and were obviously negatively correlated with the contents of sIgA and Alb(P all<0.05).Conclusion Urine KIM-1 and NGAL leve

关 键 词：慢性肾病 肾损伤分子1 中性粒细胞明胶酶相关脂质运载蛋白 肠道免疫屏障 

分 类 号：R692[医药卫生—泌尿科学]