摘要
目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)联合尿微量白蛋白(mAlb)在高血压肾病早期诊断中的临床意义。方法选择已确诊原发性高血压患者(EH)107例,根据尿蛋白排泄率(UAER)标准分为正常白蛋白尿组(30例),微量白蛋白尿组(39例),大量白蛋白尿组(38例);另选取40名健康体检者为对照组。比较各组的血清肌酐(Cr)、尿NGAL及尿mAlb等临床指标,根据CockroffGault公式计算eGFR。结果大量蛋白尿组患者和对照组受试者尿NGAL、尿mAlb和血清Cr水平均显著高于正常蛋白尿组和微量蛋白尿组患者,eGFR水平显著低于正常蛋白尿组和微量蛋白尿组患者,差异有统计学意义(P<0.05)。与大量蛋白尿组患者比较,对照组受试者尿NGAL、尿mAlb和血清Cr水平上升更明显,eGFR下降更显著,差异有统计学意义(P<0.05)。尿NGAL与eGFR呈负相关(r=-0.729,P<0.01),与尿mAlb呈正相关(r=0.516,P<0.01),尿NGAL与尿mAlb的曲线下面积(AUC)显著高于血清Cr和eGFR,差异有统计学意义(P<0.01);尿NGAL与尿mAlb间的曲线下面积比较,差异无统计学意义(P>0.05)。结论尿NGAL联合尿mAlb检测可以作为原发性高血压患者早期肾损伤诊断的指标。
Objective To investigate the clinical value of urine neutrophil gelatinase-associated lipocalin and urine microalbumin combination detection in early diagnosis of hypertensive nephropathy. Methods One hundred and seven patients with primary hypertension were recruited in this study. According to the level of UAER （urinary albumin excreting rate）, these 107 patients were divided into three subgroups： 30 patients in group A （normal albumin level in urine） , 39 patients in group B （micro albumin level in urine） and 38 patients in group C （clinical albuminuria）. Another 40 healthy adults were recruited in this study as control group. The levels of urine NGAL, urine microalbumin and serum creatinine in each patients were recorded. The value of eGFR （estimated glomerular filtration rate ） was calculated according to the formula of Cockroff-Gauh. Results Comparing with group A and group B, the levels of urine NGAL, urine microalbumin and serum creatinine in group C and group D were markedly increased（ P〈0.05 ）. A negative correlation can be found between the level of urine NGAL and eGFR（r=-0.729, P〈0.01 ）. And the level of urine NGAL positively correlated with mAlb concentration. ROC curve analysis showed that the urine NGAL and urine microalbumin in the early diagnosis of hypertensive nephropathy were superior to serum Cr（ P〈0. 05 ）. Comparison of area under the curve of urinary NGAL and urinary mAlb, there was no statistically significant difference （P〉0.05）. Conclusions Urine NGAL and urine mieroalbumin combined detection can be served as an efficient tool for early renal injury diagnosis in hypertensive nephropathy.
出处
《齐齐哈尔医学院学报》
2017年第19期2281-2282,共2页
Journal of Qiqihar Medical University
