危重症患者胸腔积液中NGAL浓度的临床意义  

Clinical significance of NGAL concentration in pleural effusion of critically ill patients

作　　者：陈兰春[1] 陈辉雄[1] 丘自挺[1] 范银强[1] 唐玮欣 余雪涛[1] 霍开秀[1] CHEN Lan-chun;CHEN Hui-xiong;QIU Zi-ting;FAN Yin-qiang;TANG Wei-xin;YU Xue-tao;HUO Kai-xiu(Longgang District People＇s Hospital of Shenzhen, Shenzhen, Guangdong 518172, China)

机构地区：[1]深圳市龙岗区人民医院,广东深圳518172

出　　处：《热带医学杂志》2018年第6期769-772,共4页Journal of Tropical Medicine

基　　金：深圳市龙岗区科技创新局(YLWS20140606165813815)

摘　　要：目的探讨危重症患者胸腔积液中性粒细胞明胶蛋白酶相关载脂蛋白(NGAL)的浓度及其临床意义。方法 31例ICU危重症且出现胸腔积液患者,其中渗出性胸腔积液的患者21例为渗出组,漏出性胸腔积液的患者10例为漏出组,分别检测胸腔积液中NGAL浓度,同时对入选患者进行急性生理学和慢性健康评估(APACHEⅡ评分)。胸腔积液中的NGAL浓度的测定采用酶联免疫吸附法(ELISA)。结果两组患者的APACHEⅡ评分、年龄差异无统计学意义(t=0.92、0.65,P=0.36、0.52)。渗出组的NGAL高于漏出组的NGAL(t=4.61,P=0.00),差异有统计学意义。胸水中NGAL浓度与血浆中NGAL浓度具有显著相关性(r=0.833,P=0.010);胸水NGAL浓度与胸水中(白细胞(WBC)计数、白蛋白及乳酸脱氢酶(LDH)水平等均具有显著相关性(r=0.467、0.447、0.473;P=0.008、0.012、0.007)。结论胸水中NGAL的水平可能可作为胸膜腔炎症渗出的一个比较敏感的生化指标,有助于鉴别胸腔积液的性质。Objective To determine the concentration of neutrophil gelatinase associated lipocalin（NGAL） in pleural effusionof the critically ill patients and investigate its clinical significance.Methods A total of 31 patients with pleural effusion inintensive care unit（ICU） were enrolled; 21 were identified as exudates and 10 as transudates.Pleural fluid and serial bloodsamples were collected from patients for NGAL measurements,and acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） score was determined.The concentration of NGAL in plasma and pleural fluid was measured by enzyme-linkedimmunosorbent assay（ELISA）.Results There were no significant differences in APACHE Ⅱ score（t=0.92,P=0.36）andage（t=0.65,P=0.52）between the two groups.The concentrations of NGAL in exudates were higher than those in transudates（t=4.61,P=0.00）.Linear correlation was found between plasma NGAL and NGAL in pleural effusions（r=0.833,P=0.010）,and NGAL between white blood cell counts（WBC）,albumin and lactic dehydrogenase（LDH） levels in pleural effusions aswell（r=0.467,0.447 and 0.473,respectively;P=0.008、0.012 and 0.007,respectively）.Conclusion NGAL could be anothersensitive biomarker for differentiation between transudates and exudates,and help identifying pleural effusions.

关 键 词：中性粒细胞明胶蛋白酶相关性载脂蛋白 胸腔积液 鉴别诊断 

分 类 号：R561[医药卫生—呼吸系统]