摘要
目的评估尿液肾损伤因子1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、单核细胞趋化蛋白1(MCP-1)对狼疮肾炎(LN),特别是肾小管间质损伤的临床价值。方法采用酶联免疫吸附试验(ELISA)法检测LN患者尿液KIM-1、NGAL、MCP-1水平,评估其与临床及病理特征的相关性,采用受试者工作特征曲线(ROC曲线)分析其诊断效能。结果活动期LN患者KIM-1、NGAL、MCP-1水平显著高于恢复期患者及健康对照组(P<0.05);尿液KIM、NGAL与eGFR、血清肌酐、尿蛋白呈正相关(均P<0.05);患者的临床表现不同,尿液KIM-1、NGAL、MCP-1水平的升高程度不同;尿液KIM水平与活动性指数AI、细胞性新月体、毛细血管内细胞增生、小管萎缩呈正相关(P<0.05);尿液NGAL/MCP-1水平与细胞性新月体呈正相关(P<0.05);活动性肾小管间质损伤患者的尿液KIM-1、MCP-1水平显著高于慢性肾间质损伤患者(P<0.05);同时伴有活动性与慢性肾小管间质损伤的患者尿液KIM-1、NGAL、MCP-1水平显著高于仅有慢性肾小管间质损伤的患者(P<0.05)。ROC曲线分析表明,3种指标联合检测可较好地预测活动性肾小管间质损伤。结论尿液KIM-1、NGAL、MCP-1联合检测在预测肾间质损伤方面有较好的临床价值。
Objective To evaluate the clinical value of urinary renal injury factor-1(KIM-1),neutrophil gelatinase related lipid delivery protein(NGAL),monocyte chemoattractant protein-1(MCP-1)in lupus nephritis(LN),especially tubules interstitial injury.Methods The levels of KIM-1,NGAL and MCP-1 in urine of LN patients were detected by enzyme-linked immunosorbent assay(ELISA).The correlation with clinical and pathological features was evaluated,and the diagnostic efficacy was evaluated by receiver operating characteristic curve(ROC curve).Results The levels of KIM-1,NGAL and MCP-1 in active LN patients were significantly higher than those in convalescent LN patients and healthy controls(P<0.05).The levels of urine KIM-1,NGAL and MCP-1 were positively correlated with eGFR,SCr and urine protein(P<0.05).Urine KIM level was significantly correlated with AI score,cellular crescents,endocapillary hypercellualrity,tubular atrophy(P<0.05),urine NGAL and MCP-1 level were significantly correlated with cellular crescents(P<0.05).The levels of KIM-1 and MCP-1 in urine of patients with active tubulointerstitial injury were significantly higher than those of patients with chronic tubulointerstitial injury(P<0.05).The levels of KIM-1,NGAL and MCP-1 in urine of patients with both active and chronic tubulointerstitial lesions were significantly higher than those with only chronic tubulointerstitial lesions(P<0.05).ROC curve analysis showed that the combined detection of the three indicators can better predict active tubulointerstitial injury.Conclusion Urine KIM-1,NGAL,MCP-1 combined detection has good clinical value in predicting renal interstitial injury.
作者
李鑫
陈雪雯
LI Xin;CHEN Xuewen(Department of Clinical Laboratory,Santan Hospital of Nankai District,Tianjin 300193,China;Department of Clinical Laboratory,Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine,Tianjin 300120,China)
出处
《检验医学与临床》
CAS
2021年第16期2358-2361,共4页
Laboratory Medicine and Clinic
