高血压肾病患者血清同型半胱氨酸及中性粒细胞明胶酶相关脂质运载蛋白检测的意义

The significance of serum homocysteine and neutrophil gelatinase associated lipocalin detection in patients with hypertensive nephropathy

目的分析血清同型半胱氨酸(Hcy)和尿液中性粒细胞明胶酶相关脂质运载蛋白(NGAL)对高血压肾病的诊断价值,并探讨尿清蛋白排泄率(UAER)与Hcy、NGAL水平的关系。方法选取2012年1月至2014年1月黄石市中心医院肾内科和心血管内科门诊高血压患者103例,分为大量蛋白尿组36例,微量蛋白尿组35例,尿蛋白正常组32例。另外,在体检中心随机选择33例体检健康者作为对照组。检测上述纳入研究者的血清Hcy、NGAL水平及UAER。结果大量蛋白尿组和微量蛋白尿组血清Hcy和NGAL水平均高于尿蛋白正常组和对照组,差异均有统计学意义(P<0.05)。大量蛋白尿组和微量蛋白尿组血清Hcy和NGAL水平比较,差异有统计学意义(P<0.05)。尿蛋白正常组和对照组血清Hcy和NGAL水平比较,差异无统计学意义(P>0.05)。高血压肾病患者UAER与血清Hcy、NGAL水平均呈正相关(r分别为0.792、0.658,P<0.05)。结论监测高血压肾病患者血清Hcy和尿液NGAL水平有助于了解其病情变化。

Objective To analyse the clinical significance of serum homocysteine（Hcy） and neutrophil gelatinase‐associated li‐pocalin（NGAL） in patients with hypertensive nephropathy ,and explore the relationship between serum homocysteine ,NGAL con‐centration and Urinary albumin excretion rate（UAER） .Methods 103 patients with hypertension treated in renal and cardiovascular department of Huangshi Central Hospital from January 2012 to June 2014 were enrolled in the study and were divided into 3 groups ：macroalbuminuria group （36 cases） ,microalbuminuria group （35 cases） and negative albuminuria group （32 cases） .In addi‐tion to that ,33 healthy people were recruited as control group .Serum homocysteine ,NGAL concentration and UAER were meas‐ured for the peple enrolled in the study .Results Serum homocysteine and NGAL concentration of macroalbuminuria group and mi‐croalbuminuria group were much higher than negative albuminuria group and control group（P〈0 .05） .Serum homocysteine and NGAL concentrations compared between macroalbuminuria group and microalbuminuria group were significantly different （P〈0 .05） .Serum homocysteine and NGAL concentrations of negative albuminuria group and control group were not significantly dif‐ferent（P〉0 .05） .UAER was positively correlated with serum homocysteine and NGAL concentration（r=0 .792 ,0 .658 ,P〈0 .05） . Conclusion The detection of serum homocysteine and NGAL are helpful in understanding the changes of disease in patients with hypertensive nephropathy .