尿中性粒细胞明胶酶相关性脂质运载蛋白与狼疮肾炎活动性及病理类型的相关性研究  

Urine neutrophil gelatinase-associated lipocalin as a biomarker of disease activity and pathological types in lupus nephritis

作　　者：李东川[1] 王祥花[1] 李臻[1] 马瑞霞[1] 

机构地区：[1]青岛大学附属医院肾内科,266003

出　　处：《中华风湿病学杂志》2015年第3期176-179,I0002,共5页Chinese Journal of Rheumatology

基　　金：山东省青岛市科技局项目[2012-1-3-2-（2）-nsh]

摘　　要：目的探讨尿中性粒细胞明胶酶相关性脂质运载蛋白（uNGAL）水平与LN活动性及病理类型的关系。方法选择初次诊治经肾活检病理检查确诊为LN的患者30例及10名健康体检者作对照组，收集相关临床、病理资料、血尿标本，ELISA法测血、尿NGAL水平，采用单因素方差分析和Pearson相关分析进行统计学分析，分析其与LN相关临床、病理指标的关系。结果30例LN活动组19例，非活动组11例。血浆NGAL水平：IJN组活动组（64±6）ng／ml、非活动组（58±20）ng／ml、健康对照组（57±20）ng／ml差异无统计学意义（P〉0．05）；尿NGAL水平：LN活动组（69±3）ng／ml、非活动组（66±5）ng／ml均高于正常对照组（64±5）ng／ml（P值分别为0．009、0．016），且LN活动组高于非活动组（P=0．012）；LN活动组尿NGAL水平与SLEDAI评分、SLE肾脏活动指数（R-SLEDAI）评分、肾小球活动指数（GAI）、肾小管间质活动指数（TLAI）、肾脏病理活动指数（AI）呈正相关（r=0．472、0．521、0．502、0．516、0．597；P：0．042、0．036、0．042，0．021，0．007）；不同病理类型之间NGAL浓度比较结果示：Ⅳ型LN尿NGAL水平（69．7±2．4）ng／rot高于Ⅲ型LN（65．3±3．2）ng／ml、V型LN（64．6±5．0）ng／ml（P值分别为0．031、0．028），受试者工作特征曲线（ROC）表明尿NGAL在诊断Ⅳ型LN时敏感度（86．7％）及特异度（73.3％）较高。结论LN患者尿NGAL水平升高，与LN活动性及肾脏病理活动，可用于监测LN病情活动，指导诊治，并可能作为诊断Ⅳ型LN的一种无创性指标。Objective To investigate the relationship between urine neutrophil gelatinase-associated lipoealin （uNGAL） level and activity and pathological types of lupus nephritis （LN）. Methods Thirty cases of biopsy proven LN patients as the initial onset were enrolled into the study. Ten healthy persons were selected as controls. The clinical and pathological data and blood, urine specimen were collected. The uNGAL was mea- sured by enzyme linked immunosorbent assay. The relationship between uNGAL and clinical and pathological features of LN was analyzed. One-way analysis of variance （ANOVA） and Pearson＇s correlation analysis were used for statistical analysis. Results Nineteen cases were in the LN active group and 11 cases were in the inactive group. The level of plasma NGAL had no significant difference between the active LN group [（64±6） ng/ml] and the inactive LN group [（58±20） ng/ml] and the healthy control group [（57±20） ng/ml] （P〉0.05）. The level of urine NGAL in the active LN group [（69±3） ng/ml] and inactive LN group [（66±5） ng/ml] was higher than that in the healthy control group [（64±5） ng/ml, P=0.009, 0.016, respectively]. Urine NGAL level in active LN group was higher thala that in the inactive group （P=0.012）. Urine NGAL level was positively correlated with SLEDAI, R-SLEDAI, GAI, TLAI, AI （r=0.472, 0.521, 0.502, 0.516, 0.597, respectively, P=0.042, 0.036,.. 0.042, 0.021, 0.007, erspectively）. The urine NGAL concentration after comparing to different pathological conditions were： urine NGAL＇s level [（69.7±2.4） ng/ml] of type 1V LN was higher than type ⅢN [（65.3±3.2） ng/ml] and type V [（64.6±5.0） ng/ml] （P=-0.03 1, 0.028, respectively）. Receiver operating characteristic （ROC） indicated that uNGAL was more sensitive（86.7% ） and specific （73.3%） for the diagnose of type IV LN than type Ⅲ or type V LN. Conclusion uNGAL is closely related with disease activity and pathological activity in LN. uNGAL enables clinician to

关 键 词：狼疮肾炎 红斑狼疮 系统性 中性粒细胞明胶酶相关脂质运载蛋白 疾病活动指数 

分 类 号：R593.242[医药卫生—内科学]