尿中性粒细胞明胶酶相关脂质运载蛋白与狼疮性肾炎活动性的相关性研究

Study on relationship between urinary neutrophil gelatinase-associated lipocalin and disease activity in lupus nephritis

目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)与狼疮性肾炎(Lupus nephritis,LN)活动性的相关性。方法选择SLE患者121例,其中LN 86例,非LN 35例。狼疮性肾炎中活动性LN 54例,非活动性32例,选择30例健康者作为对照组。检测各组中ds DNA、尿NGAL、肌酐等指标,计算SLEDAI及r SLE DAI分值,并分析其相关性。结果采用Pearson相关性分析显示,尿NGAL、尿NGAL/Cr均和SLEDAI呈正相关,相关系数分别为r=0.570、r=0.588,P<0.001。在预测活动性LN中发现尿NGAL/Cr的曲线下面积(AUC)为0.954(95%CI:0.912~0.995),当尿NGAL/Cr>2.56 ng/mg,预测活动性LN的敏感度为96.3%,特异度为81.3%。结论尿NGAL/Cr在预测LN活动性上有较好的特异性及敏感性,值得临床加以关注。

Objective To investigate the relationship between urine neutrophil gelatinase-associated lipocalin(NGAL)and disease activity in lupus nephritis(LN).Methods This study included 121 systemic lupus erythematosus(SLE)patients,86with lupus nephritis and 35 without as well as 30 matched controls.85 lupus nephritis patients were divided into active lupus nephritis group(n=54)and inactive lupus nephritis group(n=32).The indexes of ds DNA,urine NGAL,creatinine and other indicators in each group were measured,the SLEDAI and r SLE DAI scores were calculated,and their correlation was determined.Results Pearson correlation analysis showed that urine NGAL and urine NGAL/Cr were positively correlated with SLEDAI,with correlation coefficients(r)of 0.570,0.588,(P<0.001).In addition,in the prediction of active LN,it was found that the area under the curve(AUC)of urinary NGAL/Cr was 0.954(95%CI:0.912-0.995).When urine NGAL/Cr was greater than 2.56 ng/mg,the sensitivity and specificity of active LN were predicted to be 96.3%and 81.3%.Conclusion Urine NGAL/Cr has good specificity and sensitivity in predicting LN activity,which deserves clinical attention.