原发性肾病综合征合并急性肾损伤患者尿中性粒细胞明胶酶相关脂质运载蛋白和肾损伤因子1的变化及其意义  

Significance of urine neutrophil gelatinase associated lipocalin and kidney injure molecule-1 in patients with primary nephropathy syndrome with acute kidney injury

作　　者：李绍梅[1] 薛雯[1] 温文龙[1] 张丽萍[1] 张春霞[1] 闫喆[1] 段建召[1] 

机构地区：[1]河北医科大学第二医院肾内科,石家庄050000

出　　处：《中国综合临床》2013年第12期1287-1290,共4页Clinical Medicine of China

摘　　要：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）恤g／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）彬L]和KIM-1浓度[（3．60±0．92）｜Lg／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p2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。Objective To investigate the significance of neutrophil gelatinase associated lipocalin （ NGAL） and kidney injury molecule-1 （KIM-1） in the patients of primary nephropathy 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 A

关 键 词：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 

分 类 号：R692.3[医药卫生—泌尿科学]