肾盂输尿管连接部梗阻患儿行肾盂成形术前后尿液中单核细胞趋化蛋白-1和中性粒细胞明胶酶相关脂质运载蛋白水平变化及意义

The level of monocyte chemotactic peptide - 1 and neutrophil gelatinase - associated lipocalin in u- rine in children with ureteropelvic junction obstruction pre - and post - operation

目的探讨肾盂输尿管连接部梗阻（uPJo）患儿行。肾盂成形术前后，尿液中单核细胞趋化蛋白-1（MCP-1）和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的水平变化及意义。方法选取87例UPJO患儿作为观察组，另选取50例行腹股沟疝修补术患儿作为对照组，采用酶联免疫吸附试验（ELISA）比较两组患儿在术前和术后尿液中MCP-1和NGAL水平的变化，计算截点，并根据截点值评价两者联合检测UPJO的效果。结果术前观察组患儿尿中MCP-1[（121．42±19．67）pg／mg]和NGAL[（32．64±5．31）ng,／mg]，水平显著高于对照组[MCP-1：（66．56±10．33）pg,／mg；NGAL：（8．24±2．01）ng/mg，P〉0．05]，且于术中至术后24h持续升高，术后第3周开始下降，术后3个月降至与对照组差异无统计学意义（P〉0．05）；ROC曲线计算截点值：MCP-1为100．58pg／mg，NGAL为11．40pg／mg；MCP．1和NGAL联合检测UPJO的灵敏度为90．14％，特异度为75．00％，假阳性率为25．00％，假阴性率为9．86％，Youden指数为0．6514。结论UPJO患儿尿液中MCP-1和NGAL水平显著上升，炎性反应对肾小管造成损伤。

Objective To investigate the changes of monocyte chemotactic peptide - 1 （ MCP - 1 ） and neutrophil gelatinase - associated lipocalin （NGAL） levels in urine of children with ureteropelvic junc- tion obstruction （ UPJO ） before and after the operation. Methods Eighty - seven children with UPJO served as the observation group, and 50 children subject to inguinal hernia repair as the control group. MCP - 1 and NGAL levels in urine were tested by enzyme linked immunosorbent assay （ELISA） before and after the operation, then the critical point was calculated. Results The levels of NGAL [ （ 32. 64± 5.31 ） ng/mg] and MCP - 1 [ （ 121.42±19. 67 ） pg/mg] were significantly higher in the observation group than in the control group [ MCP - 1 ： （66. 56 ± 10. 33 ） pg/mg; NGAL： （8.24± 2. 01 ） ng/mg,P 〉 0. 05 ] , peri - and post - operatively, the levels of MCP - 1 and NGAL were continuously increased. Un- till the third week after the operation, the obsersation group had no significant difference with the control group （ P 〉 0. 05 ）. When the critical point of MCP - 1 was 100. 58 pg/mg, and that of NGAL was 11.40 pg/mg, the sensitivity was 90. 14%, the specificity was 75.00%, the false positive rate was 25.00%, the false negative rate was 9. 86%, and the Youden index was 0. 651 4. Conclusion The levels of MCP - 1 and NGAL in urine of children with UPJO are significantly increased, and the inflammatory re- action damage to renal tubular injury.