维持性血透患者血清NGAL水平与体内铁存储的相关性研究

The Relationship Between Neutrophil Gelatinase-associated Lipocalin and Iron Status in Dialysis Patients

目的:探讨在维持性血液透析患者,其血清NGAL(中性粒细胞明胶酶相关载脂蛋白)水平与体内铁存储的关系。方法:从2010年10月开始,我们纳入我院血液透析患者人数150例,同时纳入50例健康人为对照。收集患者及健康对照人群的人口学资料、相关的临床和生化学资料,透析前后NGAL及透析前CRP、转铁蛋白饱和度、铁蛋白、血清铁、转铁蛋白等。做透析前血清NGAL与CRP、转铁蛋白饱和度、铁蛋白、血清铁、转铁蛋白相关性分析。评估NGAL水平在判断体内铁存储的价值。结果:(1)血液透析患者其血清NGAL透析前水平为(445.45±50.34)ng/ml,透析后为(369±50.34)ng/ml,差异有统计学意义(P<0.05)。(2)血液透析患者其血清NGAL水平与CRP、spKt/V、TSAT等指标均有正相关关系(P<0.05),但与铁蛋白、血清铁、转铁蛋白无明显线性关系(P>0.05)。在多元线性回归模型中,NGAL水平与CRP、spKt/V、TSAT有相关关系(P<0.05)。(3)ROC曲线表明,NGAL水平较铁蛋白更好的反映体内铁存储情况,但差异无统计学意义(P>0.05)。结论:在血液透析患者,血清NGAL与spKt/V、CRP、TSAT有不同程度的正相关。血清NGAL能较好的反映体内铁存储情况。

Objective：To explore the relationship between serum neutrophil gelatinase-associated lipocalin（NGAL） level and iron status in a cohort of 150 dialyzed patients.Methods：150 haemodialysis patients and 50 healthy one as control are recruited since December 2010 in our hospital.Collect the demographic,clinical and laboratory data and measure the serum concentration of NGAL（before and after single haemodialysis session）,CRP,transferrin saturation（TSAT）,serum iron,serum ferritin,serum transferrin.Probe the correlation between NGAL and spKt/V,CRP,serum ferritin,transferrin saturation（TSAT）,serum iron,serum transferrin.Evaluate the diagnostic potentials of NGAL in identifying the iron status.Results：（1）with the concentration of（445.45±50.34） ng/ml,concentration of serum NGAL in dialysis patients before single haemodialysis session is significant high compared to those after single haemodialysis session（369±50.34） ng/ml（P0.05）;（2）serum NGAL is positive linear correlated to CRP、spKt/V、TSAT（%）（P0.05）,but not to serum ferritin,serum iron,serum transferrin（P0.05）.In multiple regression analysis,CRP、spKt/V、TSAT（%） are the predictors of NGAl in haemodialyzed patients（P0.05）;（3）ROC analysis shows that serum NGAL is better than serum ferritin at identifying the conditions of iron status.Conclusion：Serum level of NGAL is positive correlated to spKt/V、CRP、TSAT% in dialyzed patients;serum NGAL can reflect the iron status in dialyzed patients.