尿中性粒细胞明胶酶相关脂质运载蛋白与高血压患者早期肾损伤的相关性研究

Relationship between Urinary Neutrophil Gelatinase-associated Lipocalin and Early Renal Impairment in Patients with Hypertension

【目的】探讨尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)与高血压患者早期肾损伤的相关性。【方法】在本院治疗的125例高血压患者(高血压组),根据24h尿微量白蛋白排泄率(UAER)分为大量蛋白尿组(A组)、微量蛋白尿组(B组)、正常蛋白尿组(C组),同时选取健康志愿者作为对照组。比较各组的血肌酐(SCr)、尿素氮(BUN)、尿NGAL及肾小球滤过率(eGFR),分析尿NGAL与SCr、BUN、eGFR的相关性,采用受试者工作曲线(ROC曲线)分析尿NGAL诊断高血压患者早期肾损伤的价值。【结果】与对照组对比,高血压组SCr、BUN、尿NGAL水平均显著升高,eGFR水平显著降低(均P<0.05)。A组、B组的SCr、BUN、尿NGAL水平均高于C组,eGFR均低于C组(均P<0.05)。A组BUN、尿NGAL水平均高于B组(均P<0.05),A组SCr、eGFR水平与B组比较,差异无统计学意义(均P>0.05)。死亡组的SCr、BUN、尿NGAL水平均高于生存组,eGFR低于生存组(均P<0.05)。Pearson相关性分析显示:尿NGAL水平与SCr、BUN显著正相关(均P<0.05),与eGFR呈负相关(P<0.05)。尿NGAL诊断高血压早期肾功能受损的ROC曲线的AUC为0.884,当截断点为78.9ng/mL时,灵敏度、特异度分别为87.2%和84.9%。【结论】尿NGAL水平在高血压患者中显著升高,其水平与早期肾损伤程度呈正相关,可作为诊断高血压患者早期肾损伤的可靠指标。

【Objective】To investigate the relationship between urinary neutrophil gelatinase-associated lipocalin(NGAL)and early renal impairment in patients with hypertension.【Methods】A total of 125 patients with hypertension who were treated in our hospital were recruited in the study.According to the 24-hour urine microalbumin excretion rate,a large number of proteinuria group(A group),micro-proteinuria group(B group)and normal proteinuria in the group(C group)were grouped.Healthy volunteers were selected as the control group.The serum creatinine(SCr),urea nitrogen(BUN),urinary NGAL and glomerular filtration rate(eGFR)were compared among those groups.The correlation of urinary NGAL to SCr,BUN and eGFR was analyzed.The ROC curve was used to analyze the value of urinary NGAL in the diagnosis of early renal damage in patients with hypertension.【Results】Compared with the control group,the SCr,BUN,and urinary NGAL levels in the hypertension group significantly increased,while the eGFR levels significantly decreased(P<0.05).The SCr,BUN and urinary NGAL levels in the A group and B group were higher than those in the C group,while the levels of eGFR in both A and B groups were lower than that in the C group(P<0.05).The levels of BUN and urinary NGAL in the A group were higher than those in the B group(P<0.05).There was no significant difference in the levels of SCr and eGFR between the A group and B group(P>0.05).The SCr,BUN,and urinary NGAL levels in the death group were higher than those in the survival group,and the eGFR was lower than the survival group(P<0.05).Pearson correlation analysis showed that urinary NGAL level was positively correlated with SCr and BUN,and negatively correlated with eGFR(P<0.05).The AUC of the ROC curve for urinary NGAL diagnosis of impaired renal function in early stage of hypertension was 0.884.When the cut-off point was 78.9 ng/mL,the sensitivity and specificity were 87.2% and 84.9%,respectively.【Conclusion】The level of urinary NGAL is significantly elevated in patients with hypertension,and its level is positively correlated with the degree of early renal injury.It can be used as a reliable indicator for the diagnosis of early renal injury in hypertension.