中性粒细胞明胶酶相关载脂蛋白与IgA肾病早期诊断及病理分级的关系  

Neutrophil Gelatinase-associated Lipocalin as An Indicator of Early Diagnosis and Pathological Grading of IgA Nephropathy

作　　者：张虹[1] 童俊容[1] 王寅[1] 罗正茂[1] 何凤[1] 黄远航[1] 刘宏[1] 王妍春[1] 张建林[1] 曾健英[1] 

机构地区：[1]广州军区广州总医院肾内科,广东省广州市510010

出　　处：《中国全科医学》2012年第8期868-870,共3页Chinese General Practice

基　　金：国家自然科学基金(81170765);广东省科技计划项目(2011B061200034);广东省科技计划项目(2011B061300020)

摘　　要：目的探讨IgA肾病患者血清及尿液中性粒细胞明胶酶相关载脂蛋白(NGAL)与IgA肾病早期诊断及病理分级的关系。方法选择IgA肾病患者89例,根据Lee氏分级LeeⅠ～Ⅱ级42例(A组),LeeⅢ～Ⅴ级47例(B组);对照组33例。应用ELISA法检测3组受检者的血清及尿液中的NGAL水平并比较不同病理分级患者在系膜增殖、新月体、肾小球硬化方面的差异,分析血清及尿液的NGAL水平与系膜增殖评分的相关关系。结果 IgA肾病患者血清及尿液的NGAL水平均较对照组升高(P<0.05);Lee氏Ⅰ～Ⅱ级患者的系膜增殖程度、肾小球硬化程度、新月体数目与Lee氏Ⅲ～Ⅴ级患者比较差异均有统计学意义(P<0.05);血清及尿液的NGAL水平均与系膜增殖积分呈正相关(血清NGAL:r=0.543,P=0.016;尿液NGAL:r=0.761,P=0.007)。结论 NGAL可能在IgA肾病的病理生理学方面起重要作用,尿液NGAL可能成为判断IgA肾病患者早期肾损伤及预后的有效指标。Objective To explore the correlation between neutrophil gelatinase - associated lipocalin （NGAL） and the early .diagnosis and the pathological grading of IgA nephropathy （ IgAN）, Methods We selected 89 patients with IgA nephropa- thy and, according to Lee＇s grading method, divided them into Lee Ⅰ - Ⅱ group A （n =42） and Lee Ⅲ - Ⅴ group B （n =47）. Meanwhile, 30 healthy subjects were enrolled as the control group. NGAL in serum and urine was measured using enzyme linked immunosorbent assay （ELISA） to compare the differences of mesangial proliferation, crescent formation, and glomerular sclerosis in patients with different pathological grades; meanwhile, the correlation of sNGAL and uNGAL with the mesangial pro-liferation score was explore. Results Both sNGAL and uNGAL levels were significantly higher in IgAN patients than those in control group （ P 〈 0. 05 ）. The differences in mesangial proliferation, crescent formation, and glomerular sclerosis were statisti- cally significant between Lee Ⅰ - Ⅱ patients and Lee Ⅲ - Ⅴ patients （P 〈 0. 05 ）. Both sNGAL level and uNGAL level werepositively correlated with mesangial proliferation score （ sNGAL： r = 0. 543, P = 0. 016 ; uNGAL; r = 0. 761, P = 0. 007 ）. Conclusion NGAL may play an important role in the pathophysiology of IgAN. uNGAL may act as an effective biomarker in the early diagnosis of kidney damage and prognosis of IgAN patients.

关 键 词：中性粒细胞明胶酶相关载脂蛋白 肾小球肾炎 IGA 早期诊断 

分 类 号：R692.6[医药卫生—泌尿科学]