中性粒细胞明胶酶相关脂质运载蛋白在慢性肾病新分期中的临床意义  

Clinical significance of neutrophil gelatinase-associated lipocalin in new stages of chronic kidney disease

作　　者：兰亚婷[1] 张洪瑞[1] 向代军[1] 王成彬[1] 

机构地区：[1]解放军总医院临床检验科,北京100853

出　　处：《检验医学与临床》2015年第22期3291-3293,3296,共4页Laboratory Medicine and Clinic

基　　金：国家科技支撑计划(2013BAI17B05);全军医学技术研究"十二五"重大专项研究课题(AWS11Z005-4)

摘　　要：目的探讨中性粒细胞明胶酶相关脂质运载蛋白（NGAL）在不同分期慢性肾病（CKD）中的临床价值。方法选取2012年5月至2013年12月解放军总医院明确诊断为CKD的患者240例,按照美国肾脏病与透析患者生存质量指导指南（K/DOQI）制订的CKD分期标准分为6组,即CKD 1期组、CKD 2期组、CKD 3a期组、CKD 3b期组、CKD 4期组、CKD 5期组,应用胶乳增强免疫比浊法测定血液NGAL（sNGAL）浓度,对sNGAL在CKD中的应用价值进行横断面研究。结果在CKD各分期中,随着病变程度的增加,eGFR的减少,sNGAL浓度呈明显升高趋势（P〈0.01）。sNGAL与eGFR呈明显负相关（P〈0.05）。sNGAL浓度在CKD 3b期组明显高于CKD 3a期组（P〈0.05）。在ROC曲线分析中,诊断肾功能轻中度损伤时,血清标本sNGAL同CysC、sβ2-MG曲线下面积相似（0.903、0.945、0.937）,在诊断肾功能轻度损伤中,血清sNGAL、CysC、sβ2-MG水平ROC曲线下面积相似（0.819、0.899、0.900）。sNGAL在CKD 3-5期的临床诊断界值为CKD 3a期189.5g/L、CKD 3b期222.0g/L、CKD 4期259.0g/L、CKD 5期317.5g/L。结论 NGAL对CKD患者的肾损伤程度有一定的诊断价值。Objective To explore the clinical value of the neutrophil gelatinase-associated lipocalin（NGAL）in different stages of chronic kidney disease（CKD）.Methods According to the criteria of CKD stage formulated by KDOQI/KDIGO,240 patients with CKD in our hospital from May 2012 to December 2013 were divided into 6groups including the CKD stage 1,2,3a,3b,4and 5.The serum NGAL level was tested by the latex-enhanced immunoturbidimetric assay.The application value of sNGAL in CKD was performed the cross-sectional study.Results The NGAL level showed the significantly increasing trend with the increase of the CKD severity and the decline of the eGFR（P〈0.01）.The sNGAL level was negatively correlated with eGFR（P〈0.05）.The sNGAL level in the CKD 3b stage group was significantly higher than that in the CKD 3astage group（P〈0.05）.In the ROC curve analysis,for diagnosing mild and moderate renal function impairment,serum sample sNGAL was similar to the areas under curve（AUC）of CysC and sβ2-MG（0.903,0.945,0.937）,for diagnosing mild renal function impairment,serum sNGAL,CysC and sβ2-MG levels had similar AUC of ROC curve（0.819,0.899,0.900）.The clinical diagnostic values of sNGAL were 189.5g/L for CKD 3astage,222.0g/L for CKD 3bstage,259.0g/L for CKD 4stage and 317.5g/L for CKD 5stage.Conclusion NGAL has certain diagnostic value for the renal function impairment degree of CKD.

关 键 词：中性粒细胞明胶酶相关脂质运载蛋白 慢性肾病 诊断 

分 类 号：R735.102[医药卫生—肿瘤]