肾损伤分子-1等生物标记物在模拟高强度军事训练急性肾损伤中的早期诊断作用  

Roles of KIM-1, NGAL and IL-18 in early detection of acute kidney injury caused by high intensity military training in the rat model

作　　者：陈洪[1,2] 周春华[2] 李斌[2] 张朝阳[2] 白晓龙[2] 

机构地区：[1]第二军医大学,上海200433 [2]海军总医院

出　　处：《中华航海医学与高气压医学杂志》2014年第1期38-42,50,共6页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的 探讨肾损伤分子-1（kidney injury molecule-1,KIM-1）、中性粒细胞明胶酶相关脂质运载蛋白（neutrophilgelatinase associated lipocalcin,NGAL）、白细胞介素-18（interteukin-18,IL-18）3种生物学标记物早期诊断大鼠模拟高强度军事训练致急性肾损伤（acute kidney injury,AKI）的效能.方法 雄性12周龄SD大鼠10只为尿检组,构建高强度军事训练AKI模型,留取训练前及训练后不同时间段尿液;48只为血检组,按完全随机方法分为6组,每组8只.按训练前、训练后0、6、12、24、48 h取血清.分别检测尿液、血清KIM-1、NGAL、IL-18及传统诊断指标.结果 训练后即刻,血清、尿液KIM-1、NGAL、IL-18的水平均较对照组明显升高,IL-18升高峰值在2 h,KIM-1、NGAL在6h达峰值,48 h恢复至对照组水平.尿液中KIM-1、NGAL的水平与尿蛋白无相关,与白蛋白、N-乙酰-β-D-氨基葡萄糖甘酶（N-acetyl-β-D-glucosaminidase,NAG）呈正相关.尿IL-18的水平与尿蛋白、白蛋白、NAG呈正相关（P＜0.05）.血清中KIM-1、NGAL、IL-18的水平与尿素氮（blood urea nitrogen,Bun）、血清肌酐（serum creatinine,SCr）呈正相关.受试者工作曲线（ROC）分析显示训练后各时间点曲线下面积值（AUC）尿液中KIM-1、NGAL、IL-18均大于尿蛋白、尿白蛋白、尿NAG酶,血清中KIM-1、NGAL、IL-18的AUC值均大于Bun、SCr,血清、尿液相应标志物的AUC值一致.结论 高强度军事训练致AKI后,早期即可探测到血清、尿液KIM-1、NGAL、IL-18的水平升高,诊断效能优于传统诊断标志物,尿液检测可满足诊断要求.Objective To investigate early diagnostic efficacy of the kidney injury molecule-1 （KIM-1）,neutrophilgelatinase associated lipocalcin （NGAL） and interleukin-18 （IL-18） in acute kidney injury （AKI） induced by high intensity military training through the rat model.Methods Ten male SD rats,12 weeks old,were used as the urine detection group to develop the animal model of AKI induced by high intensity military training.Urine samples were taken at different time points both before and after training.Another 48 SD rats were designated as the blood detection group and serum samples were collected before training and at hours 0,6,24 and 48 after training.Changes in the urine and serum concentration of KIM-1,NGAL,IL-18 and routine markers were detected respectively.Results The urine and serum KIM-1,NGAL and IL-18 all increased significantly the moment after termination of training,as compared with those of the control group （P＜0.05）.IL-18 reached peak at hour 2,KIM-1 and NGAL reached peak at hour 6,and then they decreased to baselines in 48 hours.Urine KIM-1 and NGAL were not correlated with urine protein,while they were positively correlated with urine albumin （UA） and NAG.Urine IL-18 was positively correlated with urine protein,urine albumin （UA） and NAG（P ＜0.05）.Serum KIM-1,NGAL and IL-18 were positively correlated with serum Cr and Bun.ROC analysis showed that the levels of urine KIM-1,NGAL and uIL-18 in the area under the curve （AUC） at various time points after training were all higher than those of urine protein,UA and NAG.The AUC value of serum KIM-1,NGAL and IL-18 were all higher than those of SCr and Bun at any time points after training,and it was corresponding to the AUC value of the serum and urine biomarkers.Conclusions Following acquired acute kidney injury induced by high intensity military training,higher levels of serum and urine KIM-1,NGAL and IL-18 could be detected immediately after training.The diagnostic efficiency was superior to those traditional markers.Uri

关 键 词：动物模型 肾 急性肾损伤 军事医学 肾损伤分子-1 中性粒细胞明胶酶相关脂质运载蛋白 白细胞介素-18 

分 类 号：R692[医药卫生—泌尿科学] R-332[医药卫生—外科学]