摘要
目的探讨一氧化氮(NO)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、超氧化物歧化酶(SOD)等实验室指标与慢性肾病(CKD)分级的相关性。方法CKD组选取135例肾病非透析病人,男64例,女71例,年龄区间26~94岁。根据改善全球肾脏病预后组织(KDIGO)2012《评估管理慢性肾病指南》对入组CKD患者进行分级,1期和2期31例,3期41例,4期39例,5期24例。对照组选取健康体检人群25例,男14例,女11例,年龄区间21~71岁。检测研究对象血清样本NO、SOD、NGAL、肌酐(CREA)、胱抑素C(CysC),并基于CKD-EPI CREA-CysC公式计算肾小球滤过率(eGFR)。结果与对照组相比,CKD各组血清样本中NO、NGAL水平显著升高(P<0.05),水平与病情进展正相关;SOD水平显著降低(P<0.05)。CKD前后3月eGFR呈持续性下降。受试者工作特征曲线(ROC)分析表明,NGAL和NO诊断1期以上慢性肾病的曲线下面积分别为0.834和0.625,诊断灵敏度分别为69.4%和67.2%,诊断特异性分别为87.5%和58.3%。两者联合使用,曲线下面积为0.845,诊断灵敏度为84.4%,特异性为72.0%。结论在慢性肾病早期患者中,NGAL和NO明显升高,两者联合检测可提高诊断灵敏度和特异性,建议作为CKD早期诊断指标。
Objective To investigate the hierarchical correlation between nitric oxide(NO),neutrophil gelatinase-associated lipocalin(NGAL),and superoxide dismutase(SOD)with chronic kidney disease.Methods A total of 135 patients with kidney disease were selcted for the study,in which 47.4%were 64 males and 52.6%of 71 females,with aged from 26 to 94 years and graded according to the Global Organization for Improving the Prognosis of Kidney Disease(KDIGO)2012 Assessment Guidelines for the Management of Chronic Kidney Disease.There were 25 cases in the control group,of which 14 were males accounted for 56%and 11 females accounted for 44%,aged from 21 to 71 years.Levels of NO,SOD,NGAL,CREA,CysC,and eGFR of the subjects were tested,and eGFR was calculated based on CKD-EPI CREA-CysC formula.Results Compared with the control group,NO and NGAL levels in each types of CKD were significantly increased(P<0.05),while SOD level was decreased(P<0.05).Serum levels of NO and NGAL in patients with chronic kidney disease were higher than those in healthy patients,and their concentration levels were positively correlated with disease progression.eGFR level of the CKD patient group decreased continuously for 3 months before and after the onset of the disease.ROC analysis showed that the areas under NGAL and NO curves were 0.834 and 0.625,respectively.As to the CKD diagnosed by NGAL and NO individually,the sensitivity were 69.4%and 67.2%,and the specificity were 87.5%and 58.3%,while by NGAL and NO unity,the area under the curve was 0.845,the sensitivity was increased to 84.4%and the specificity was increased to 72.0%.Conclusion In patients with the early stage of chronic kidney disease(CKD),NGAL and NO are significantly increased compared with the control group,and the combined detection of these two markers can improve the sensitivity and specificity,which is recommended as an indicator of the early diagnosis.
作者
沈军
王弘明
黄盛
SHEN Jun;WANG Hongming;HUANG Sheng(Department of Clinical Laboratory,Shanghai General Hospital,Shanghai Jiao Tong UniversitySchool of Medicine,Shanghai 200080,China)
出处
《标记免疫分析与临床》
CAS
2023年第3期394-396,共3页
Labeled Immunoassays and Clinical Medicine
基金
上海申康医院发展中心基金(编号:SHDC2020CR3007A)。
关键词
一氧化氮
中性粒细胞明胶酶相关脂质运载蛋白
慢性肾病
肾病分级
Nitric oxide(NO)
Neutrophil gelatinase-associated lipocalin(NGAL)
Chronic kidney disease(CKD)
Grade of nephropathy
