血NGAL水平与早期原发性IgA肾病的临床分析

Clinical analysis of blood NGAL level and early primary IgA nephropathy

目的研究血中性粒细胞明胶酶相关载脂蛋白(sNGAL)水平与原发性IgA肾病临床病理的相关性,探讨血sNAGL对IgA肾病早期诊断的作用。方法 44例经肾活检确诊的原发性IgA肾病患者,根据Lee氏分级分为Lee氏Ⅰ～Ⅱ级24例(A组),Lee氏Ⅲ～Ⅴ级20例(B组);对照组26例。采用免疫层析法检测3组受检者sNGAL水平,分析sNGAL与24 h尿蛋白定量、血肌酐、血尿酸、白蛋白之间的相关性。结果 IgAN患者中B组的肌酐、尿酸、血浆白蛋白、sNGAL均高于对照组,A组患者仅有血浆白蛋白、sNGAL高于对照组(P<0.05);而IgAN患者2组间仅B组的肌酐及sNGAL高于A组(P<0.05)。sNGAL与血肌酐呈正相关性,sNGAL与eGFR呈负正相关性。结论早期IgA肾病患者sNGAL水平升高,且sNGAL与血肌酐呈正相关性、sNGAL与eGFR呈负相关性,sNGAL可作为IgA肾病的标志物评估肾脏功能。

Objective To study the correlation between serum neutrophil granulocyte-related apolipoprotein(sNGAL)level and the clinicopathology of primary IgA nephropathy,and to explore the role of blood sNAGL in the early diagnosis of IgA nephropathy.Methods 44 cases of primary IgA nephropathy confirmed by renal biopsy were divided into LeeⅠ~Ⅱgrade 24 cases(group A),LeeⅢ~Ⅴgrade 20 cases(group B)and control group 26 cases according to Lee’s classification.The levels of sNGAL in three groups were detected by immunochromatography.The correlation between sNGAL and 24 h urinary protein quantification,creatinine,uric acid and albumin was analyzed.Results The levels of creatinine,uric acid,plasma albumin and sNGAL in group B were higher than those in control group,while plasma albumin and sNGAL in group A were higher than those in control group,and the difference was statistically significant(P<0.05).Compared with Michigan,only creatinine and sNGAL in group B were higher than those in group A,and the difference was statistically significant(P<0.05).sNGAL was positively correlated with creatinine,while sNGAL was negatively correlated with eGFR.Conclusion The level of sNGAL in patients with early IgA nephropathy is increased,and sNGAL is positively correlated with serum creatinine and negatively correlated with eGFR.sNGAL can be used as a marker of IgA nephropathy to evaluate renal function.