KIM-1和NGAL对儿童紫癜性肾炎后急性肾损伤的诊断价值

Significance of kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin in the diagnosis of children with acute kidney injury caused by Henoch-Sch?nlein purpura nephritis

目的探讨新型标志物肾损伤分子-1(KIM-1)和中性粒细胞明胶酶相关脂质运载蛋白(NGAL)对儿童紫癜性肾炎后急性肾损伤(A-on-HSPN)的早期诊断价值。方法选择2018年1月至2018年10月在中国医科大学附属盛京医院小儿肾脏风湿免疫科住院的紫癜性肾炎(HSPN)肾病综合征型患儿16例及A-on-HSPN患儿9例,留取血、尿和肾脏病理组织,采用ELISA方法检测血及尿KIM-1、NGAL含量,免疫组化法检测KIM-1、NGAL在患儿肾脏中的表达。结果A-on-HSPN组患儿血、尿KIM-1、NGAL水平明显高于HSPN组(P<0.05);KIM-1、NGAL表达于肾小管上皮细胞,且A-on-HSPN组患儿肾脏组织中KIM-1、NGAL表达明显高于HSPN组(P<0.05);尿KIM-1、NGAL水平和肾小球滤过率(GFR)呈负相关,而与24 h尿蛋白定量无明显相关性。结论KIM-1和NGAL可作为早期诊断儿童A-on-HSPN的生物标志物。

Objective To explore the value of kidney injury molecule-1(KIM-1)and neutrophil gelatinase-associated lipocalin(NGAL)in the early diagnosis of acute kidney injury caused by Henoch-Sch¨onlein purpura nephritis(A-on-HSPN)in children.Methods A prospective clinical study involved children with HSPN and children with A-on-HSPN who were admitted to the Department of Pediatric Nephrology,Shengjing Hospital from January 2018 to October 2018.Blood,urine and pathological kidney tissues were collected.The levels of NGAL and KIM-1 in blood and urine were detected by ELISA,and the expression of NGAL and KIM-1 in pathological kidney tissues was detected by immunohistochemistry.Results The levels of KIM-1 and NGAL in the blood and urine of the A-on-HSPN group were significantly higher than those of the HSPN group(P<0.05).KIM-1 and NGAL were expressed in renal tubular epithelial cells,and the expression of KIM-1 and NGAL in pathological kidney tissues of the A-on-HSPN group was significantly higher than that of the HSPN group(P<0.05).The levels of KIM-1 and NGAL reveal an obvious positive correlation with glomerular filtration rate(GRF)and no significant correlation with 24 h urinary protein levels.Conclusion KIM-1 and NGAL may be biomarkers for the early diagnosis of A-on-HSPN in children.