检验医学 ›› 2015, Vol. 30 ›› Issue (4): 327-330.DOI: 10.3969/j.issn.1673-8640.2015.04.008

• 临床应用研究·论著 • 上一篇    下一篇

尿NGAL与CKD肾小管间质损伤的相关性研究

张科1, 刘彧崟1, 张春2, 张德太1   

  1. 1. 华中科技大学同济医学院附属协和医院检验科,湖北 武汉430022
    2. 华中科技大学同济医学院附属协和医院肾内科,湖北 武汉430022
  • 收稿日期:2014-06-19 出版日期:2015-04-30 发布日期:2015-05-16
  • 作者简介:null

    作者简介:张 科,男,1981年生,学士,主管技师,主要从事临床生化检测工作。

    通讯作者:张德太,联系电话:027-85726355。

The correlation research of urinary NGAL and CKD renal tubulointerstitial injury

ZHANG Ke1, LIU Yuyin1, ZHANG Chun2, ZHANG Detai1   

  1. 1. Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Wuhan 430022, China
    2. Nephrology Department,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430022,China
  • Received:2014-06-19 Online:2015-04-30 Published:2015-05-16

摘要:

目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)与慢性肾脏病(CKD)肾小管间质损伤的相关性。方法测定124例行肾穿刺的CKD患者及30名健康体检者(正常对照组)血清半胱氨酸蛋白酶抑制剂C(Cys C)、尿NGAL、尿视黄醇结合蛋白(RBP)、尿β2-微球蛋白(β2-MG)水平,对尿NGAL与血清Cys C、尿RBP、尿β2-MG进行相关性分析。依据肾穿刺活检结果将肾小管间质损伤程度分为轻度损伤、轻-中度损伤、中度损伤、中-重度损伤4组,采用Spearman等级相关分析尿NGAL与肾小管间质损伤程度的相关性。采用受试者工作特征(ROC)曲线评价尿NGAL诊断CKD肾小管间质损伤的性能。结果CKD各组尿NGAL均明显高于正常对照组(P均=0.000),随着肾小管间质损伤程度的加重,尿NGAL水平逐渐升高,各组间差异均有统计学意义(P均<0.05)。尿NGAL与尿RBP、尿β2-MG和血清Cys C均呈正相关(r=0.784、0.692、0.759,P均<0.01)。尿NGAL水平与肾小管间质损伤程度呈正相关(r=0.762,P<0.01)。尿NGAL诊断CKD肾小管间质损伤的ROC曲线下面积为0.855;当最佳临界点为45.35 ng/mL时,敏感性为77.2%,特异性为84.6%。结论尿NGAL可以作为反映CKD肾小管间质损伤的标志物,对于CKD诊断、治疗和预后具有一定的临床意义。

关键词: 中性粒细胞明胶酶相关脂质运载蛋白, 慢性肾脏病, 肾小管间质, 损伤

Abstract:

Objective To study the correlation of urinary neutrophil gelatinase-associated lipocalin (NGAL) with chronic kidney disease (CKD) renal tubulointerstitial injury. Methods A total of 30 healthy subjects (healthy control group) and 124 patients with CKD undergoing renal biopsy were enrolled. Serum cystatin C (Cys C), urinary NGAL, urinary retinol binding protein (RBP) and urinary beta2-microglobulin (β2-MG) were determined. Correlation analysis was carried out on urinary NGAL with serum Cys C, urinary RBP and urinary β2-MG. According to the degrees of renal biopsy results, renal tubulointerstitial injury was classified into mild injury, mild to moderate injury, moderate injury and severe injury groups. By Spearman rank, the correlation of urinary NGAL with CKD renal tubulointerstitial injury was analyzed. The performance of urinary NGAL for the diagnosis of CKD renal tubulointerstitial injury was analyzed by receiver operating characteristic (ROC) curve. Results The urinary NGAL of CKD groups was significantly higher than that of control group (P=0.000). With the increasing of CKD renal tubulointerstitial injury, urinary NGAL increased gradually, and the differences were statistically significant (P<0.05). The urinary NGAL was positively correlated with urinary RBP, urinary β2-MG and serum Cys C (r=0.784, 0.692 and 0.759, P<0.01). There was positive correlation between urinary NGAL and renal tubulointerstitial injury (r=0.762, P<0.01). The area under ROC curve was 0.855, and the optimal cut-off point was 45.35 ng/mL. The sensitivity was 77.2%, and the specificity was 84.6%. Conclusions Urinary NGAL contributes to the diagnosis, treatment and prognosis of CKD renal tubulointerstitial injury, which is a novel biomarker for the disease.

Key words: Neutrophil gelatinase-associated lipocalin, Chronic kidney disease, Renal tubulointerstitial, Injury

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