妊娠合并慢性肾炎患者血清和尿液中NGAL的检测意义
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摘要
目的:探讨妊娠合并慢性肾炎患者血清和尿液中中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的检测意义。方法:选取2016年2月—2017年2月本院收治的74例妊娠合并慢性肾炎患者为观察组,另选正常健康妊娠妇女58例为对照组,采用酶联免疫吸附法测定血清和尿液中NGAL水平,并统计肌酐(Scr)、尿素氮(BUN)、24h尿蛋白定量(24-Upro)、肾小球滤过率(GFR)等指标,应用Pearson相关分析对血清和尿液NGAL水平及两者与Scr、BUN、24-Upro间关系进行相关性分析,应用受试者工作特征(ROC)曲线评估血清和尿液中NGAL诊断价值。结果:观察组Scr、BUN、24-Upro均高于对照组,GFR则低于对照组(P<0.05);血清与尿液中NGAL水平均高于对照组(P<0.05)。血清和尿液中NGAL呈正相关,且分别与Scr、BUN、24-Upro呈正相关,与GFR呈负相关(P<0.05);NGAL诊断价值尿液高于血清,血清NGAL以389.87ng/ml为截断值,其敏感度、特异度、约登指数分别为86.7%、69.5%、0.562;尿液NGAL以392.02ng/ml为截断值,其敏感度、特异度、约登指数分别为86.7%、76.3%、0.6。结论:NGAL在妊娠合并慢性肾炎患者血清和尿液中异常升高,尿液NGAL诊断价值较高,临床检测NGAL水平利于及时诊治。
Objective: To investigate the significance of level of serum and urine neutrophil gelatinase associated lipoprotein(NGAL) detection of pregnant women with chronic glomerulonephritis during pregnancy. Methods: 74 pregnant women with chronic glomerulonephritis from February 2016 to February 2017 were selected in observation group, and 58 normal healthy pregnant women were selected in control group. Enzyme-linked immunosorbent assay was used to determine the level of NGAL in serum and urine of women, and the values of creatinine(Scr), urea nitrogen(BUN), 24-hour urinary protein(24-Upro) and glomerular filtration rate(GFR) were also measured. Pearson correlation analysis was used to analyze the correlation between serum and urine NGAL levels, and their relationships with values of Scr and BUN and 24-Upro. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of serum and urine NGAL levels. Results: The values of Scr, BUN and 24-Upro of women in observation group were significant higher than those of women in control group, while GFR of women in observation group was significant lower than that of women in control group(P<0.05). The levels of serum and urine NGAL of women in observation group were significant higher than those of women in control group(P<0.05).The level of serum NGAL was positive correlation with level of urine NGAL. And the levels of serum and urine NGAL were positive correlation with values of Scr, BUN and 24-Upro, and were negative correlated with value of GFR(P<0.05).The diagnostic significance of urine NGAL level was higher than that of serum NGAL level. The truncated value of serum NGAL level was 389.9 ng/ml, and its sensitivity, specificity and Jorden index was 86.7%, 69.5% and 0.562, respectively. The truncated value of urine NGAL level was 392.0 ng/ml, and its sensitivity, specificity and Jorden index was 86.7%, 76.3% and 0.6, respectively. Conclusion: The levels of serum and urine NGAL of pregnant women with chronic nephritis abnormally increase, and the diagnostic value of urine NGAL level is higher than that of urine NGAL level. The clinical detection of serum and urine NGAL levels is benefit for diagnosis and treatment of patients timely, and it is important for improving patient's prognosis.
Objective: To investigate the significance of level of serum and urine neutrophil gelatinase associated lipoprotein(NGAL) detection of pregnant women with chronic glomerulonephritis during pregnancy. Methods: 74 pregnant women with chronic glomerulonephritis from February 2016 to February 2017 were selected in observation group, and 58 normal healthy pregnant women were selected in control group. Enzyme-linked immunosorbent assay was used to determine the level of NGAL in serum and urine of women, and the values of creatinine(Scr), urea nitrogen(BUN), 24-hour urinary protein(24-Upro) and glomerular filtration rate(GFR) were also measured. Pearson correlation analysis was used to analyze the correlation between serum and urine NGAL levels, and their relationships with values of Scr and BUN and 24-Upro. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of serum and urine NGAL levels. Results: The values of Scr, BUN and 24-Upro of women in observation group were significant higher than those of women in control group, while GFR of women in observation group was significant lower than that of women in control group(P<0.05). The levels of serum and urine NGAL of women in observation group were significant higher than those of women in control group(P<0.05).The level of serum NGAL was positive correlation with level of urine NGAL. And the levels of serum and urine NGAL were positive correlation with values of Scr, BUN and 24-Upro, and were negative correlated with value of GFR(P<0.05).The diagnostic significance of urine NGAL level was higher than that of serum NGAL level. The truncated value of serum NGAL level was 389.9 ng/ml, and its sensitivity, specificity and Jorden index was 86.7%, 69.5% and 0.562, respectively. The truncated value of urine NGAL level was 392.0 ng/ml, and its sensitivity, specificity and Jorden index was 86.7%, 76.3% and 0.6, respectively. Conclusion: The levels of serum and urine NGAL of pregnant women with chronic nephritis abnormally increase, and the diagnostic value of urine NGAL level is higher than that of urine NGAL level. The clinical detection of serum and urine NGAL levels is benefit for diagnosis and treatment of patients timely, and it is important for improving patient's prognosis.
引文
[1]陈艳,何静,邓俊娜,等.慢性肾病管理模式下狼疮性肾炎合并妊娠患者的护理[J].中国实用护理杂志,2016,32(20):1540-1541.
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[3]郭佳.妊娠高血压综合征早期肾损伤患者血清mALB、Urea、NGAL、Cys-C变化及检测意义[J].中国计划生育学杂志,2018(2):111-114.
[4]马玉珠.妊娠合并慢性肾炎诊断与处理[J].中国实用妇科与产科杂志,1999,15(9):516-517.
[5]王亿平,王东,徐文静,等.参地颗粒对慢性肾炎脾肾亏虚证患者肾小球内皮细胞的干预作用[J].中国中西医结合急救杂志,2016,23(4):360-363.
[6]Fredi M,Gregorini G,Zatti S,et al.Identifying and managing lupus nephritis during pregnancy[J].Expert Opinion on Orphan Drugs,2016,4(10):1-11.
[7]陈有维,唐娟,何乐愚,等.血清PCT与sICAM-1和sVCAM-1在慢性肾炎患者细菌感染中的应用[J].中华医院感染学杂志,2017,27(19):4359-4362.
[8]史亚男,叶文玲.IgA肾病与妊娠相关的研究进展[J].国外医学医学地理分册,2016,37(3):276-279.
[9]张瑞英,赵迅,王学敏,等.妊娠相关AKI患者Cys-C、SCr和NGAL水平变化及其在诊断和预后判断中的价值[J].中国妇幼健康研究,2017,28(11):1395-1398.
[10]尹晓茜,张艳红,霍琰.NGAL与妊娠相关疾病的研究进展[J].国际生殖健康/计划生育杂志,2018,37(02):158-161.
[11]Ahlawat R S,Batra V,Pendharkar S.Urinary TWEAK and NGAL as a biomarker of lupus nephritis activity[J].Journal of the Association of Physicians of India,2016,64(1):69.
[12]吴寿坤,伍义,罗文晓,等.血清及尿中性粒细胞胶原酶相关脂质运载蛋白水平与脓毒症急性肾损伤患者肾功能转归的关系[J].临床和实验医学杂志,2016,13(13):1291-1294.
[13]黄菁,郑美玲,王玉珏,等.尿肾损伤分子1、血清胱抑素C和尿中性粒细胞明胶酶相关性脂质运载蛋白预测子痫前期发病和早期肾损伤的价值[J].中国医科大学学报,2016,45(5):460-463.
[14]Eilenberg W,Stojkovic S,Piechotapolanczyk A,et al.Neutrophil Gelatinase-Associated Lipocalin(NGAL)is Associated with Symptomatic Carotid Atherosclerosis and Drives Proinflammatory State In Vitro.[J].European Journal of Vascular&Endovascular Surgery,2016,51(5):623-631.
[15]李平华,宋倩,黄连铭.血清肌酐、胱抑素C、NGAL检测对妊娠相关急性肾损伤诊断及预后评估的价值[J].中国计划生育学杂志,2017,25(5):308-313.
[16]赵舒,严滨.中性粒细胞明胶酶相关脂质运载蛋白与妊娠期高血压疾病的相关性研究[J].贵州医药,2017,41(8):817-820.
[17]dum L,Andersen A S,Hviid T V.Urinary neutrophil gelatinase-associated lipocalin(NGAL)excretion increases in normal pregnancy but not in preeclampsia[J].Clinical Chemistry&Laboratory Medicine Cclm,2014,52(2):221.
[18]稂琳璐.血清脂质运载蛋白、胱抑素C和尿β?2微球蛋白在妊娠高血压患者早期肾损伤诊断中的价值[J].中国临床医生杂志,2017,45(6):55-58.
[2]Cabiddu G,Castellino S,Gernone G,et al.A best practice position statement on pregnancy in chronic kidney disease:the I-talian Study Group on Kidney and Pregnancy[J].Journal of Nephrology,2016,29(3):277-303.
[3]郭佳.妊娠高血压综合征早期肾损伤患者血清mALB、Urea、NGAL、Cys-C变化及检测意义[J].中国计划生育学杂志,2018(2):111-114.
[4]马玉珠.妊娠合并慢性肾炎诊断与处理[J].中国实用妇科与产科杂志,1999,15(9):516-517.
[5]王亿平,王东,徐文静,等.参地颗粒对慢性肾炎脾肾亏虚证患者肾小球内皮细胞的干预作用[J].中国中西医结合急救杂志,2016,23(4):360-363.
[6]Fredi M,Gregorini G,Zatti S,et al.Identifying and managing lupus nephritis during pregnancy[J].Expert Opinion on Orphan Drugs,2016,4(10):1-11.
[7]陈有维,唐娟,何乐愚,等.血清PCT与sICAM-1和sVCAM-1在慢性肾炎患者细菌感染中的应用[J].中华医院感染学杂志,2017,27(19):4359-4362.
[8]史亚男,叶文玲.IgA肾病与妊娠相关的研究进展[J].国外医学医学地理分册,2016,37(3):276-279.
[9]张瑞英,赵迅,王学敏,等.妊娠相关AKI患者Cys-C、SCr和NGAL水平变化及其在诊断和预后判断中的价值[J].中国妇幼健康研究,2017,28(11):1395-1398.
[10]尹晓茜,张艳红,霍琰.NGAL与妊娠相关疾病的研究进展[J].国际生殖健康/计划生育杂志,2018,37(02):158-161.
[11]Ahlawat R S,Batra V,Pendharkar S.Urinary TWEAK and NGAL as a biomarker of lupus nephritis activity[J].Journal of the Association of Physicians of India,2016,64(1):69.
[12]吴寿坤,伍义,罗文晓,等.血清及尿中性粒细胞胶原酶相关脂质运载蛋白水平与脓毒症急性肾损伤患者肾功能转归的关系[J].临床和实验医学杂志,2016,13(13):1291-1294.
[13]黄菁,郑美玲,王玉珏,等.尿肾损伤分子1、血清胱抑素C和尿中性粒细胞明胶酶相关性脂质运载蛋白预测子痫前期发病和早期肾损伤的价值[J].中国医科大学学报,2016,45(5):460-463.
[14]Eilenberg W,Stojkovic S,Piechotapolanczyk A,et al.Neutrophil Gelatinase-Associated Lipocalin(NGAL)is Associated with Symptomatic Carotid Atherosclerosis and Drives Proinflammatory State In Vitro.[J].European Journal of Vascular&Endovascular Surgery,2016,51(5):623-631.
[15]李平华,宋倩,黄连铭.血清肌酐、胱抑素C、NGAL检测对妊娠相关急性肾损伤诊断及预后评估的价值[J].中国计划生育学杂志,2017,25(5):308-313.
[16]赵舒,严滨.中性粒细胞明胶酶相关脂质运载蛋白与妊娠期高血压疾病的相关性研究[J].贵州医药,2017,41(8):817-820.
[17]dum L,Andersen A S,Hviid T V.Urinary neutrophil gelatinase-associated lipocalin(NGAL)excretion increases in normal pregnancy but not in preeclampsia[J].Clinical Chemistry&Laboratory Medicine Cclm,2014,52(2):221.
[18]稂琳璐.血清脂质运载蛋白、胱抑素C和尿β?2微球蛋白在妊娠高血压患者早期肾损伤诊断中的价值[J].中国临床医生杂志,2017,45(6):55-58.