妊娠合并慢性肾炎患者血清和尿液中NGAL的检测意义

The significances of level of serum and urine NGAL detection of pregnant women with chronic glomerulonephritis during pregnancy

目的:探讨妊娠合并慢性肾炎患者血清和尿液中中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的检测意义。方法:选取2016年2月—2017年2月本院收治的74例妊娠合并慢性肾炎患者为观察组,另选正常健康妊娠妇女58例为对照组,采用酶联免疫吸附法测定血清和尿液中NGAL水平,并统计肌酐(Scr)、尿素氮(BUN)、24h尿蛋白定量(24-Upro)、肾小球滤过率(GFR)等指标,应用Pearson相关分析对血清和尿液NGAL水平及两者与Scr、BUN、24-Upro间关系进行相关性分析,应用受试者工作特征(ROC)曲线评估血清和尿液中NGAL诊断价值。结果:观察组Scr、BUN、24-Upro均高于对照组,GFR则低于对照组(P<0.05);血清与尿液中NGAL水平均高于对照组(P<0.05)。血清和尿液中NGAL呈正相关,且分别与Scr、BUN、24-Upro呈正相关,与GFR呈负相关(P<0.05);NGAL诊断价值尿液高于血清,血清NGAL以389.87ng/ml为截断值,其敏感度、特异度、约登指数分别为86.7%、69.5%、0.562;尿液NGAL以392.02ng/ml为截断值,其敏感度、特异度、约登指数分别为86.7%、76.3%、0.6。结论:NGAL在妊娠合并慢性肾炎患者血清和尿液中异常升高,尿液NGAL诊断价值较高,临床检测NGAL水平利于及时诊治。

Objective: To investigate the significance of level of serum and urine neutrophil gelatinase associated lipoprotein(NGAL) detection of pregnant women with chronic glomerulonephritis during pregnancy. Methods: 74 pregnant women with chronic glomerulonephritis from February 2016 to February 2017 were selected in observation group, and 58 normal healthy pregnant women were selected in control group. Enzyme-linked immunosorbent assay was used to determine the level of NGAL in serum and urine of women, and the values of creatinine(Scr), urea nitrogen(BUN), 24-hour urinary protein(24-Upro) and glomerular filtration rate(GFR) were also measured. Pearson correlation analysis was used to analyze the correlation between serum and urine NGAL levels, and their relationships with values of Scr and BUN and 24-Upro. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of serum and urine NGAL levels. Results: The values of Scr, BUN and 24-Upro of women in observation group were significant higher than those of women in control group, while GFR of women in observation group was significant lower than that of women in control group(P<0.05). The levels of serum and urine NGAL of women in observation group were significant higher than those of women in control group(P<0.05).The level of serum NGAL was positive correlation with level of urine NGAL. And the levels of serum and urine NGAL were positive correlation with values of Scr, BUN and 24-Upro, and were negative correlated with value of GFR(P<0.05).The diagnostic significance of urine NGAL level was higher than that of serum NGAL level. The truncated value of serum NGAL level was 389.9 ng/ml, and its sensitivity, specificity and Jorden index was 86.7%, 69.5% and 0.562, respectively. The truncated value of urine NGAL level was 392.0 ng/ml, and its sensitivity, specificity and Jorden index was 86.7%, 76.3% and 0.6, respectively. Conclusion: The levels of serum and urine NGAL of pregnant women with chronic nephritis abnormally increase, and the diagnostic value of urine NGAL level is higher than that of urine NGAL level. The clinical detection of serum and urine NGAL levels is benefit for diagnosis and treatment of patients timely, and it is important for improving patient’s prognosis.