糖尿病肾病患者尿液中性粒细胞明胶酶相关载脂蛋白及肾损伤分子-1水平变化及意义

摘要

Objective To explore the changes of urinary NGAL and KIM - 1 in patients with diabetic nephropathy and their clinical significance. Methods 70 patients with type 2 diabetes mellitus ( T2DM ) admitted to our hospital were divided into normal albuminuria group ( NA group, 28 cases ), micro albuminuria group ( MI group, 22 cases ) and macro albuminuria group ( MA group, 20 cases ) according to albumin - to - creatinine ratio ( ACR ) . Meanwhile, 23 non - diabetic and non - nephropathy patients were involved as control group. The levels of NGAL and KIM - 1 of the four groups were detected by ELISA and were then analyzed. The correlation of urine NGAL/urine Cr, urine KIM - 1/urine Cr and ACR/urine Cr was also analyzed. Results ( 1 ) The blood glucose levels of NA group, MI group and MA group were all significantly higher than that of the control group ( P all < 0. 05 ) . The GFR level of the MA group was significantly lower than the other three groups ( P all < 0. 05 ). The SCr level of the MA group was significantly higher than the other three groups ( P all <0. 05 ) . The urine NGAL/urine Cr and urine KIM - 1/urine Cr in MI group and MA group were significantly higher than the control group and NA group ( P all < 0. 05 ) . ( 2 ) The urine NGAL/urine Cr were positively correlated with ACR/urine Cr ( r = 0. 864, P < 0. 001 ), and the urine KIM - 1/urine Cr were also positively correlated with ACR/urine Cr ( r = 0. 835, P < 0. 001 ) . Conclusion NGAL and KIM - 1 may play an important role in the occurrence and development of DN, and urine NGAL and KIM - 1 might be predictors of the severity of DN.%目的 探讨糖尿病肾病(DN)患者尿液中性粒细胞明胶酶相关载脂蛋白(NGAL)、肾损伤分子- 1(KIM-1)的水平变化及意义.方法 选择在我院治疗的2型糖尿病(T2DM)患者70例,根据尿清蛋白/肌酐比值(albumin-to creatinine ratio,ACR)分为正常清蛋白尿组(NA组)28例、微量清蛋白尿组(MI组)22例、大量清蛋白尿组(MA组)20例;同期选取23例非糖尿病、非肾脏病患者作为对照组.应用ELISA法检测4组患者尿液NGAL、KIM-1的水平并比较,同时分析尿 NGAL/尿肌酐(Cr)及尿 KIM-1/尿Cr与ACR/尿Cr之间的相关关系.结果 (1)NA组、MI组、MA组的GLU水平均高于对照组,差异有统计学意义(P均＜0.05).MA组的肾小球滤过率(GFR)较其他3组降低,差异有统计学意义(P均＜0.05).MA组的血肌酐(SCr)水平较其他3组升高,差异有统计学意义(P均＜0.05).MI组和MA组的尿NGAL/尿Cr、尿KIM-1/尿Cr均较对照组和NA组升高,差异均有统计学意义(P均＜0.05).(2)糖尿病患者尿NGAL/尿Cr与ACR/尿Cr呈正相关性(r=0.864,P＜0.001),尿KIM-1/尿Cr与ACR/尿Cr亦呈正相关性(r=0.835,P＜0.001).结论 NGAL、KIM-1可能参与了DN的发生与发展,尿NGAL、KIM-1有望成为判断DN肾损害程度的指标之一.