中性粒细胞明胶酶相关脂质运载蛋白与妊娠期高血压疾病的相关性研究

Correlation research between Neutrophil gelatinase-associated lipocalin and pregnancy induce hypertension

目的研究中性粒细胞明胶酶相关性脂质运载蛋白(NGAL)与妊娠期高血压(PIH)的关系及对其早期肾损伤的预测价值。方法选取PIH患者49例,分为高血压合并蛋白尿组、高血压非蛋白尿组和对照组。ELISA法检测三组血浆、尿NGAL水平,并比较Cr和Cystatin C水平。结果研究组与对照组血浆、尿NGAL及Cystatin C水平差异有统计学意义(P<0.05),随着病情加重各指标均明显升高。蛋白尿高血压组Cr水平显著高于对照组(P<0.05),余组间无明显差异。Cystatin C与Cr呈高度正相关,Cystatin C在检出阳性率三组有显著差异,而Cr水平无明显差异。血浆、尿NGAL与Cystatin C、Cr均呈高度正相关。结论血浆、尿NGAL水平升高可能与肾损伤有关,且可能参与了PIH的病理生理过程。其水平变化与Cystatin C变化一致,Cystatin C的变化较Cr早,可将其用于PIH肾损伤的早期诊断。

Objective To investigate whether serum and urinary NGAL may have a clinical value in defining the severity of pregnancy induced hypertension and early prediction of renal damage. Methods Total of 49 women with pregnancy induced hypertension and 27 uncomplicated pregnancies was enrolled in cross-sectional case-control study. It was divided into group A（hypertenslon and proteinuria）, group B（hypertension only, and group C（control group）. Three groups patient＇s the average level of serum NGAL, urinary NGAL, cystatin C and serum creatinine were de- tected and compared. Results There were statistical significantly differences that plasma and urinary NGAL and Cys- tatin C concentrations between in patients with PIH groups and in control group（P〈0.05）. In subgroup analysis, there were statistical significantly differences that group A higher NGAL and Cystatin C concentrations than group B （P〈0.05）. Only group A had was higher creatinine concentrations than group C （P〈0.05）. Cystatin C was posi- tively correlated with creatinine. The number of cases of abnormal Cystatin C in group A and B are significantly more than that in group C（P〈0.05） ,but the number of cases of creatinine had no difference in the three groups. This fur- ther illustrate Cystatin C are more sensitive and reliable renal indicators than creatinine. Both serum and urinary NGAL concentrations were positively correlated with Cystatin C. Both serum and urinary NGAL concentrations were positively correlated with creatinine. Conclusion Plasma and urinary NGAL concentrations were correlation renal in- jury and to be associated with pathology in women with PIH. Plasma and urinary NGAL were positive correlation with Cystation C,Cr and can diagnose the primary renal injury.