供体血浆中性粒细胞明胶酶相关脂质运载蛋白水平评价活体供肾切取术后残肾功能的临床意义

目的探讨供体血浆中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)水平在评价活体供肾切取术后残肾功能中的临床意义。方法采用前瞻性研究方法,选择2018年11月至2020年10月在郑州市第七人民医院行亲属肾移植(活体供肾切取术)的供肾者98例作为研究对象。调查所有供体的一般资料,在术前1 d、术后1 d、术后1个月、术后6个月检测供体血浆NGAL水平、血肌酐、蛋白尿水平,判断残肾功能并进行预测价值分析。结果在98例供体中,术后6个月发生慢性肾功能不全18例(肾功能不全组),发生率为18.4%。两组术前1 d的血浆NGAL、血肌酐与24 h蛋白尿对比差异无统计学意义(P>0.05),肾功能不全组术后1 d、术后1个月与术后6个月的血浆NGAL、血肌酐与24 h蛋白尿高于非肾功能不全组(P<0.001)。Spearson相关分析显示供体术前1 d血浆NGAL、血肌酐与蛋白尿都与术后6个月的肾功能不全存在相关性(P<0.05)。结论供体血浆NGAL是一个非常有前景的评价活体供肾切取术后残肾功能的生物学指标,具有很好的临床应用价值。

Objective To investigate the clinical significance of donor plasma neutrophil gelatinase-associated lipocalin(NGAL)in evaluating residual renal function after living donor nephrectomy.Me thods With the prospective research method,98 renal donors who underwent relative kidney transplantation(living donor nephrectomy)in Zhengzhou Seventh People’s Hospital from November 2018 to October 2020 were selected as the research objects.The general data of all donors were investigated.The levels of plasma NGAL,serum creatinine and proteinuria were measured 1 day before operation,1 day after operation,1 month after operation and 6 months after operation to judge the residual renal function and analyze the predictive value.Re s ults Among 98 donors,18 cases(renal insufficiency group)developed chronic renal insufficiency 6 months after operation,with an incidence of 18.4%.There was no significant difference between the two groups in plasma NGAL,serum creatinin e and 24 h proteinuria 1 day before operation(P>0.05).The plasma NGAL,serum creatinine and 24 h proteinuria in renal insufficiency group were higher than those in non renal insufficiency group 1 day,1 month and 6 months after operation(P<0.001).Spearson correlation analysis showed that plasma NGAL,serum creatinine and proteinuria were correlated with renal insufficiency 6 months after operation(P<0.05).Conclus ion Donor plasma NGAL is a very promising biological index to evaluate the residual renal function after living donor nephrectomy,with good clinical application value.