中性粒细胞明胶酶相关蛋白与急性有机磷农药中毒急性肾损伤的关联研究

Research on the Association of Serum Neutrophil Gelatinase-Associated Lipocalin with Acute Kidney Injury Induced by Acute Organophosphorus Pesticide Poisoning

目的:检测急性有机磷农药中毒(acute organophosphorus pesticide poisoning,AOPP)患者血清中性粒细胞明胶酶相关蛋白(serum neutrophil gelatinase-associated lipocalin,sNGAL)的水平,并分析其与中毒程度和急性肾损伤(acute kidney inju-ry,AKI)的相关性。方法:将105例AOPP患者根据其乙酰胆碱酯酶(AchE)水平分为轻度组(35例)、中度组(38例)、重度组(32例);门诊体检健康者30例为对照组。分别检测对照组、实验组入院时、入院后1d、3d、5d的sNGAL水平,分析其与中毒程度、时间变化的相关性。结果:AOPP时AKI的发生率为86.7%,通过sNGAL诊断灵敏度为87.9%,特异度100%。入院时sNGAL的阳性率达76.2%,各中毒组的sNGAL浓度均与对照组有差异(P<0.01),其浓度和阳性率均与中毒程度高度正相关(P<0.05)。血液灌流前后sNGAL浓度有明显差异(P<0.01)。结论:sNGAL是诊断AOPP早期AKI的敏感指标,其与中毒程度呈高度正相关,能反映AKI发生及恢复的过程;血液灌流治疗利于AKI恢复。

Objective：To study the level of serum neutrophil gelatinase-assoeiated lipocalin （sNGAL） in acute organophosphorus pesticide poisoning （AOPP） patients and its relationship with acute kidney injury （AKI） . Methods：A total of 105 patients with AOPP were divided into three groups （mild, moderate and severe） according to the level of acetyleholinesterase（AchE）, while thirty healthy controls in out-patient clinic were also recruited, sNGAL was detected in all the patients at admission, as well as ld, 3d and 5d after admission. The relation of sNGAL with intoxication degree was analyzed. Results： The incidence of AKI caused by AOPP was 86.7%. The sensitivity of sNGAL is 87.9% and the specificity was 100%. The positive rate of sN- GAL was 76.2%when admission. The concentrations of sNGAL in each experiment group were significantly different from that of the control group（P〈0.01）, and it had a positive correlation with intoxication degree（P〈0.05）. There was a significant difference in the concentration of sNGAL before and after treating by perfusion（P〈0.01）. Conclusions： sNGAL is a sensitive marker for early diagnosis of AKI in AOPP, and it has a positive correlation with intoxication degree and can reflect the process of AKI. Blood perfusion is effective for AKI recovery.