尿视黄醇结合蛋白、中性粒细胞明胶酶相关脂质运载蛋白与痛风患者肾功能的关联性研究  

The Relationship Between Urinary Retinol Binding Protein,Neutrophil Gelatinase Associated Lipocalin and Renal Function in Patients with Gout

作　　者：王勇[1] 白丽杰[1] 王静[1] 赵静[1] 铁宁[1] WANG Yong;BAI Lijie;WANG Jing;ZHAO Jing;TIE Ning(Department of Rheumatology and Immunology,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010059,China)

机构地区：[1]内蒙古医科大学附属医院风湿免疫科,内蒙古呼和浩特010059

出　　处：《标记免疫分析与临床》2020年第12期2050-2053,2062,共5页Labeled Immunoassays and Clinical Medicine

基　　金：内蒙古自治区自然科学基金(编号:2017MS(LH)0839,2018MS08097)。

摘　　要：目的探讨尿视黄醇结合蛋白(RBP)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)与痛风患者肾功能的关系,并进一步分析了二者对痛风患者合并早期肾损伤的诊断价值。方法选取2018年6月到2020年6月期间在我院接受治疗的痛风患者136例,根据肾损伤情况将136例患者分为痛风组和痛风+肾损伤组,痛风+肾损伤组再根据肾小球滤过率(GFR)将其分为轻度组、中重度组。另选取同期在我院体检的健康志愿者30例作为对照组。检测所有研究对象的尿RBP、NGAL以及血清肌酐(SCr)、尿素氮(BUN)的水平。结果痛风+肾损伤组的SCr、BUN、RBP、NGAL水平高于对照组和痛风组,差异有统计学意义(P<0.05)。中重度组的SCr、BUN、RBP、NGAL水平高于轻度组,差异有统计学意义(P<0.05)。痛风患者的尿RBP、NGAL与SCr、BUN均呈正相关,且尿RBP与NGAL亦呈正相关(P<0.05)。采用ROC分析显示,尿RBP的曲线下面积为0.795(95%CI:0.705~0.884),尿NGAL的曲线下面积为0.830(95%CI:0.751~0.910)。二者联合诊断时采用并联诊断,可有效提升灵敏度和约登指数。结论尿RBP、NGAL的表达水平与痛风患者肾功能损伤程度密切相关,二者联合检测对痛风患者合并早期肾损伤有较高的诊断价值。Objective To investigate the relationship between urinary retinol binding protein(RBP),neutrophil gelatinases associated lipocalin(NGAL)and renal function in patients with gout,and to further analyze the diagnostic value of the two among gout patients with an early renal injury.Methods 136 patients with gout who were treated in our hospital from June,2018 to June,2020 were selected for the study,and they were divided into the gout group and gout+renal injury group according to the renal injury status.The patients in the gout+renal injury group was further divided into the mild group and moderate severe group according to glomerular filtration rate(GFR).Another 30 healthy volunteers who had physical examinations in our hospital during the same period were selected as the control group.The levels of urinary RBP,NGAL,serum creatinine(SCr)and urea nitrogen(BUN)of all subjects were detected.Results The levels of SCr,BUN,RBP and NGAL in the gout+renal injury group were higher than those in the control group and gout group,the differences were statistically significant(P<0.05).The levels of SCr,BUN,RBP and NGAL in the moderate and severe group were higher than those in the mild group,the differences were statistically significant(P<0.05).Urinary RBP and NGAL of patients with gout were positively correlated with SCR and BUN,and urinary RBP was positively correlated with NGAL(P<0.05).ROC analysis showed that the area under the curve of urinary RBP was 0.795(95%CI:0.705-0.884),and that of urinary NGAL was 0.830(95%CI:0.751-0.910).Parallel diagnosis was used in the joint diagnosis,and the joint diagnosis of the two markers could effectively improve the sensitivity and yoden index.Conclusion The expression levels of urinary RBP and NGAL are closely related to the degree of renal injury in patients with gout.The combined detection of RBP and NGAL has a high diagnostic value for gout patients with an early renal injury.

关 键 词：痛风 肾损伤 视黄醇结合蛋白 中性粒细胞明胶酶相关脂质运载蛋白 

分 类 号：R589.7[医药卫生—内分泌]