痛风患者尿KIM-1、NGAL、IL-18表达及与肾损伤的关系  

Expressions of Urinary KIM-1,NGAL and IL-18 in Gout Patients and Their Relationships with Renal Injury

作　　者：张弢[1] 隋淼[1] 于扬[1] 许静宜[1] 杨晓辉[1] ZHANG Tao;SUI Miao;YU Yang(Department of Endocrinology One Family,Zhongshan Hospital Affiliated to Dalian University,Dalian,116001)

机构地区：[1]大连大学附属中山医院内分泌一科,大连116001

出　　处：《中国中西医结合肾病杂志》2020年第1期25-28,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：辽宁省自然科学基金项目(No.2017020153)。

摘　　要：目的:探讨痛风患者尿肾损伤分子1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、白细胞介素-18(IL-18)表达及与肾损伤的关系。方法:选取2017年01月~2019年04月本院收治的126例痛风患者进行研究,其中将肾小球滤过率(e GFR)<90 ml·min-1·1.73 m-2分为痛风伴肾损伤组(n=54),e GFR≥90 ml·min-1·1.73 m-2患者分为痛风不伴肾损伤组(n=72),选择同期体检健康者50例作为对照组,观察受试者尿KIM-1、NGAL、IL-18水平,肾功能指标水平变化,三指标与肾功能指标相关性及对痛风伴肾损伤诊断价值。结果:痛风伴肾损伤组患者尿KIM-1、NGAL、IL-18水平均高于不伴肾损伤组、对照组(P<0.05),不伴肾损伤组尿IL-18高于对照组(P<0.05);痛风伴肾损伤组患者e GFR水平低于不伴肾损伤组、对照组(P<0.05),血清肌酐(Scr)、胱抑素C(Cys C)水平均高于不伴肾损伤组、对照组(P<0.05);痛风伴肾损伤患者尿KIM-1、NGAL、IL-18均与e GFR呈负相关(P<0.05),与Scr、Cys C呈正相关(P<0.05);ROC曲线显示,KIM-1的AUC为0.927,敏感度为83.33%,特异性为88.89%;NGAL的AUC为0.937,敏感度为85.19%,特异性为94.44%;IL-18的AUC为0.919,敏感度为77.78%,特异性为87.50%。结论:痛风伴肾损伤患者尿KIM-1、NGAL、IL-18水平升高,与肾功能指标相关,对痛风伴肾损伤早期诊断具有较高诊断价值。Objective:To investigate the expressions of urinary renal injury molecule 1(KIM-1),neutrophil gelatinase-related lipid carrier protein(NGAL),interleukin-18(IL-18)and their relationships with renal injury in gout patients.Methods:126 patients with gout were admitted to our hospital from January 2017 to April 2019 were selected for the study,among them,those with glomerular filtration rate(e GFR)<90 ml·min-1·1.73 m-2 were divided into gout complicated renal injury group(n=54),those with e GFR>90 ml·min-1·1.73 m-2 were divided into non-renal injury group(n=72),50 healthy persons in the same period were selected as control group,the levels of urinary KIM-1,NGAL and IL-18,the changes of renal function indexes,the correlations between the three indexes with renal function indexes,and the diagnostic value of gout complicated renal injury were observed.Results:The levels of urinary KIM-1,NGAL and IL-18 in patients in gout complicated renal injury group were higher than those in non-renal injury group and control group(P<0.05),the urinary IL-18 level in in non-renal injury group was higher than that in the control group(P<0.05);the level of e GFR in gout complicated renal injury group was lower than that in non-renal injury group and control group(P<0.05),the levels of serum creatinine(Scr)and cystatin C(Cys C)were higher than those of the control group and the non-renal injury group(P<0.05);KIM-1,NGAL and IL-18 were negatively correlated with e GFR(P<0.05)and positively correlated with Scr and Cys C(P<0.05);ROC curve showed that AUC of KIM-1 was 0.927,sensitivity was83.33%,specificity was 88.89%;AUC of NGAL was 0.937,sensitivity was 85.19%,specificity was 94.44%;the AUC of IL-18 was 0.919,the sensitivity was 77.78%,and the specificity was 87.50%.Conclusion:The levels of KIM-1,NGAL and IL-18 in urine of patients with gout complicated renal injury are increased,which are related to renal function indexes,and have high diagnostic value for early diagnosis of gout with renal injury.

关 键 词：痛风 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 肾损伤 

分 类 号：R589.7[医药卫生—内分泌] R692.5[医药卫生—内科学]