尿液中性粒细胞明胶酶相关脂质运载蛋白与狼疮性肾炎活动性及病理分型关系的初步研究  

Neutrophil gelatinase-associated lipocal in urine: a novel biomarker of disease activity and pathology classification for lupus nephritis

作　　者：李海英[1] 左灿[2] 卿之驹[2] 谢小兵[1] 

机构地区：[1]湖南中医药大学第一附属医院检验中心,长沙410007 [2]中南大学湘雅二医院检验科,长沙410011

出　　处：《临床检验杂志》2015年第5期359-363,共5页Chinese Journal of Clinical Laboratory Science

摘　　要：目的观察尿液中性粒细胞明胶酶相关脂质运载蛋白(u NGAL)水平与狼疮性肾炎(LN)活动性及病理分型间的关系。方法收集系统性红斑狼疮(SLE)患者104例(包括63例LN患者及41例非肾炎SLE患者)及对照者60例(包括非SLE的其他自身免疫病和健康人对照者各30例)的血液及尿液标本,用胶乳增强免疫比浊法测定NGAL。结果 LN患者u NGAL高于非肾炎SLE患者(P<0.01),而两者s NGAL水平差异无统计学意义。活动期LN患者u NGAL水平高于静止期LN患者(0.8±0.4 ng/mg Cr vs 0.5±0.3 ng/mg Cr,P<0.01)。u NGAL与肾脏SLEDAI评分呈正相关(r=0.364,P<0.01)。u NGAL判断LN活动性的ROC曲线下面积为0.756,cut off值为0.585 ng/mg Cr时,敏感性和特异性分别为70.73%和77.27%。不同病理分型LN患者间u NGAL水平差异无统计学意义(P>0.05);Ⅲ型和Ⅳ型LN患者u NGAL水平虽较其他组高,但差异无统计学意义(P>0.05)。结论 SLE患者发生肾脏病变时,u NGAL水平增高,有可能成为一种新的反映LN活动性的标志物;不同病理分型LN患者u NGAL水平无差异,不能作为增殖型LN的标志物。Objective To study urinary neutrophil gelatinase-associated lipocalin（ u NGAL） in the patients with systemic lupus erythematosus（ SLE） and analyze its association with disease activity and pathology classification for lupus nephritis（ LN）. Methods The serum and urine samples of 104 SLE patients and 60 controls were collected. SLE patients were further divided into lupus nephritis（ LN,n = 63） and non-nephritis SLE（ n = 41）. The controls consisted of 30 patients with non-SLE autoimmune diseases and 30 healthy volunteers. The concentrations of s NGAL and u NGAL were measured by latex-enhanced turbidimetric immunoassay method.Results u NGAL levels in the patients with LN were significantly higher than those without LN（ P〈0. 01） but the difference of s NGAL levels between the two groups did not showed statistical significance. In the patients with LN,u NGAL levels in active LN were higher than those in inactive LN（ 0. 8 ± 0. 4 ng / mg Cr vs 0. 5 ± 0. 3 ng / mg Cr,P〈0. 01）. u NGAL levels positively correlated with the renal score of the Systemic Lupus Erythmatosus Disease Activity Index（ SLEDAI）（ r = 0. 364,P〈0. 01）. The ROC curve of u NGAL showed the level of u NGAL at cut-off point（ 0. 585 ng / mg Cr） exhibited high sensitivity and specificity（ 70. 73% and 77. 27%respectively）（ P〈0. 01）. The area under ROC curve was 0. 756. The comparison of u NGAL levels among the groups with different WHO classes of LN yielded no significant difference（ P〉0. 05）,though the patients with LN class Ⅲ and Ⅳ had elevated u NGAL.Conclusion u NGAL levels elevated promptly in SLE patients with renal involvement. u NGAL represents a novel sensitive biomarker for predicting disease activity in LN. There was no significant difference in u NGAL levels among different types of LN. u NGAL can not be used to monitor the development of the patients with proliferative renal disease.

关 键 词：中性粒细胞明胶酶相关脂质运载蛋白 狼疮性肾炎 系统性红斑狼疮 系统性红斑狼疮疾病活动指数(SLEDAI) 

分 类 号：R446[医药卫生—诊断学]