狼疮肾炎尿液转化生长因子-β1巨噬细胞炎症蛋白-1α和中性粒细胞明胶酶相关脂质运载蛋白检测的临床意义  

Clinical values of urinary transforming growth factor-β1 macrophage inflammatory protein-1α and neutrophil gelatinase-associated hpocalin level in lupus nephritis

作　　者：石鑫岳[1] 李鸿斌[1] 肖镇[1] 张铎 龚莉 

机构地区：[1]内蒙古医学院第一附属医院风湿免疫科,呼和浩特010059 [2]内蒙古中蒙医院肾内科 [3]内蒙古医院肾内科

出　　处：《中华风湿病学杂志》2012年第1期33-37,共5页Chinese Journal of Rheumatology

摘　　要：目的拟判断尿液中转化生长因子（TGF）-β1，巨噬细胞炎症蛋白（MIP）-1α和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）与狼疮肾炎病理的相关性。方法酶联免疫吸附试验（ELISA）法检测入选对象尿液中TGF-β1，MIP—1α和NGAL的水平。分析3种尿液标记物与病理分型、Austin评分和组织学半定量评分的相关性。统计采用t检验、方差分析和，检验；相关性分析采用Pearson相关分析。结果①狼疮肾炎患者组与非肾损害SLE和健康对照组相比，尿液中TGF-β1[（351±219），（92_±60），（74±29）pg／m1]，MIP—1α[（18．0±15．5），（8．5±2．3），（7．1±1．9）pg／m1]和NGAL[（1．104±0．519），（0．181±0．030），（0．146±0．024）ng／m1]水平差异有统计学意义（F值分别为15．88，6．49，35．95；P均〈0．01），而与非狼疮肾炎肾小球疾病组患者差异无统计学意义。②在狼疮肾炎不同病理分型中3种尿液标记物差异有统计学意义（P〈0．01），但这种改变在同-病理类型中狼疮肾炎组和其他肾小球疾病组之间差异无统计学意义。③狼疮肾炎患者尿液中3种标记物与组织病理半定量评分相关性分析结果显示，尿液中TGF-β1与系膜基质增生指数（MsMI）、肾小球慢性病变指数（GCI）、肾间质萎缩和肾间质纤维化指数（TcI）、小动脉慢性病变指数（VCI）密切相关；MIP．1ct与内皮细胞增生指数（end01）、活动性新月体及节段性袢坏死（dGAI）、VCI有相关性；而NGAL与end01，dGAI，MsHI有明显相关性。而3种标记物与狼疮肾炎患者肾活检活动性和慢性指数的相关性分析结果显示，TGF-β1与慢性指数明显相关（r=0．89，P〈0．01），而MIP-1α和NGAL与活动性指数明显相关（r=0．71，P〈0．01；r=0．60，P〈0．01）。结论狼疮肾炎患者尿液中TGF-β1与肾脏的病变的慢性化相关。而MIP-1α和NGAL与肾脏活动病理相�Objective To determine whether there is correlation between the pathological classification and urinary level of transforming growth factor （TGF）-β1, macrophage inflammatory protein （MIP）-1α, and Nentrophil gelatinase-associated lipocalin （NGAL） of lupus nephritis. Methods ELISA was used to test the levels of urinary level of TGF-β1, MIP-1α and NGAL. The correlation between these three urinary markers and the pathological classifications, Austin score, histological semi-quantitative score and clinical data were analyzed. Comparisons between groups were performed with t-test, ANOVA and χ2 test. Correlation analysis was performed with Pearson analysis. Results ①There .was significant difference in urinary TGFβ1, MIP-1α, and NGAL levels when compared the lupus nephritis group, SLE patients without renal damage group and the normal control group [TGF-β1（351±219）, （92±60）, （74±29）pg/ml], [MIP-1α（18.0±15.5）, （8.5±2.3）, （7.1±1.9） pg/ml], [NGAL （1.104±0.519）, （0.181±0.030）, （0.146±0.024） ng/ml], while there was no significant difference between lupus nephritis （LN） group and patients with other glomerulonephritis. ② There was significant difference in the three urinary markers when stratified the LN patients based on the pathological classifications, however, there was no significant difference between the LN group and other glomerulonephritis group. ③ Analysis of the correlation between the three urinary markers and semiquantitative histopathological score of the LN patients showed that the urinary level of TGF-β1 and MsMI, GCI, TCI, VCI was closely related to each other, the urinary MIP-1α was related to and endol, and the dGAI and VCI was closely related, while the urinary NGAL was closely related with endol, dGAI and MsHI. The correlation analysis between the three urinary markers and acute and chronic pathological index score of the LN patients showed that TGF-β1 was correlated with the chronic index （r=0.89, P〈0.01）, the MIP-lot an

关 键 词：狼疮肾炎 尿分析 转化生长因子Β 巨噬细胞炎性蛋白质1 中性粒细胞明胶酶相关脂质运载蛋白 

分 类 号：R593.242[医药卫生—内科学]