Relationship between serum neutrophil gelatinase-associated lipocalin levels and cognitive impairment, anxiety, and depressive symptoms in acute ischemic stroke

BACKGROUND Acute ischemic stroke(AIS)is a significant global health issue with increasing incidence owing to aging populations and rising cardiovascular risk factors.In addition to physical impairments,AIS frequently leads to neuropsychiatric co-mplications,such as cognitive impairment,anxiety,and depressive symptoms,which adversely affect patients’quality of life and rehabilitation.Neutrophil ge-latinase-associated lipocalin(NGAL)has emerged as a potential biomarker for various conditions,including AIS.This study investigated the association bet-ween serum NGAL levels at admission and neuropsychiatric complications in patients with AIS.neuropsychiatric complications in patients with AIS.METHODS Between January 2022 and December 2023,150 patients with AIS were enrolled.Serum NGAL levels were measured at admission using an enzyme-linked immu-nosorbent assay.Cognitive function was assessed using the Mini-Mental State Examination,while anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale at discharge.The relationship between serum NGAL levels and cognitive impairment,anxiety,and depressive symptoms was analyzed using multivariate logistic regression,adjusted for potential con-founders of age,sex,body mass index,smoking status,hypertension,diabetes mellitus,dyslipidemia,previous stroke,and stroke severity.RESULTS The mean age of the participants was 65.4±10.2 years,and 58%were males.Prevalence rates of cognitive impairment,anxiety,and depressive symptoms at discharge were 34.7%,28.0%,and 32.0%,respectively.Serum NGAL levels were significantly higher in patients with cognitive impairment(median:5.6 ng/mL vs 3.2 ng/mL,P<0.001),anxiety(median:5.1 ng/mL vs 3.5 ng/mL,P=0.002),and depressive symptoms(median:5.4 ng/mL vs 3.3 ng/mL,P<0.001),compared to those without these conditions.Multivariate logistic regression analysis showed that higher serum NGAL levels at admission were independently associated with cognitive impairment[odds ratio(OR)=1.42,95%confidence interval(CI):1.18-1.71,P<0.001],anxiety(OR=1.28,95%CI:1.09-1.51,P=0.003),and depressive symptoms(OR=1.39,95%CI:1.16-1.67,P<0.001)after adjusting for potential confounders.CONCLUSION Elevated serum NGAL levels were independently associated with cognitive impairment,anxiety,and depressive symptoms in patients with AIS;and may function as potential biomarkers for patients at risk.

Serum Neutrophil Gelatinase-associated Lipocalin(NGAL)Is Elevated in Patients with Asthma and Airway Obstruction

Neutrophilic airway inflammation is one of the features of severe asthma.Neutrophil gelatinase-associated lipocalin(NGAL),or lipocalin-2,is a glycoprotein associated with neutrophilic inflammation and can be detected in blood.Recently,blood NGAL levels have been reported to be elevated in chronic obstructive pulmonary disease.However,the clinical significance of serum NGAL levels in patients with asthma has not been elucidated.The aim of this study was to explore the association between serum NGAL level and clinical parameters in patients with asthma.Sixty.one non-smoking people with stable asthma were enrolled in this study.All patients underwent blood ollction and pulmonary function tests.The associations between serum NGAL levels and clinical parameters were analyzed retrospectively.Serum NGAL levels in patients with asthma and obstructive ventilatory defect were higher than those in patients with asthma without obstructive ventilatory defect(76.4±51.4 ng/mL vs.39.3±27.4 ng/mL,P=0.0019).Serum NGAL levels were correlated with forced expired flow at 50%of vital capacity%predicted and forced expired flow at 75%of vital capacity%predicted(r=-0.3373,P=0.0078 and r=0.2900,P=0.0234,respectively).Results of a multiple regression analysis demonstrated that serum NGAL level was independently associated with obstructive ventilatory defect.Serum NGAL levels were elevated in patients with asthma and obstructive ventilatory defect.NGAL may be involved in airway remodeling possibly mediated by neutrophilic inflammation in asthma.

Neutrophil gelatinase-associated lipocalin does not predict acute kidney injury in heart failure

BACKGROUND Acute cardiorenal syndrome type 1(CRS-1)is defined by a rapid cardiac dysfunction leading to acute kidney injury(AKI).Neutrophil gelatinaseassociated lipocalin(NGAL)is expressed on the surface of human neutrophils and epithelial cells,such as renal tubule cells,and its serum(sNGAL)and urinary have been used to predict AKI in different clinical settings.AIM To characterize CRS-1 in a cohort of patients with acute heart diseases,evaluating the potentiality of sNGAL as an early marker of CRS-1.METHODS We performed a retrospective cohort,multi-centre study.From January 2010 to December 2011,we recruited 202 adult patients admitted to the coronary intensive care unit(CICU)with a diagnosis of acute heart failure or acute coronary syndrome.We monitored the renal function to evaluate CRS-1 development and measured sNGAL levels within 24 h and after 72 h of CICU admission.RESULTS Overall,enrolled patients were hemodynamically stable with a mean arterial pressure of 92(82-107)mmHg,55/202(27.2%)of the patients developed CRS-1,but none of them required dialysis.Neither the NGAL delta value(AUC 0.40,95%CI:0.25-0.55)nor the NGAL peak(AUC 0.45,95%CI:0.36-0.54)or NGAL cutoff(≥140 ng/mL)values were statistically significant between the two groups(CRS-1 vs no-CRS1 patients).The area under the ROC curve for the prediction of CRS-1 was 0.40(95%CI:0.25-0.55)for the delta NGAL value and 0.45(95%CI:0.36-0.54)for the NGAL peak value.Finally,in multivariate analysis,the risk of developing CRS-1 was correlated with age>60 years,urea nitrogen at admission and 24 h-urine output(AUC 0.83,SE=60.5%SP=93%),while sNGAL was not significantly correlated.CONCLUSION In our population,sNGAL does not predict CRS-1,probably as a consequence of the mild renal injury and the low severity of heart disease.So,these data might suggest that patient selection should be taken into account when considering the utility of NGAL measurement as a biomarker of kidney damage.

Combination of neutrophil gelatinase-associated lipocalin and matrix metalloproteinase-9 are biomarkers for the detection of colon tubular adenocarcinoma

BACKGROUND Tubular adenocarcinoma of the colon,which originates from the epithelium of the glands,is a major health concern worldwide.However,it is difficult to detect at an early stage.The lack of biomarkers is a main barrier to the diagnosis and treatment of tubular adenocarcinoma.Neutrophil gelatinase-associated lipocalin(NGAL)is a secreted protein that induces the expression of matrix metalloproteinase-9(MMP-9)and is involved in various tumors.NGAL and MMP-9 have been reported to be associated with tumorigenesis and development.They may have potential as biomarkers for diagnosis of tubular adenocarcinoma of the colon.AIM To determine whether NGAL and MMP-9 can be used as potential biomarkers to indicate the progression of tubular adenocarcinoma of the colon.METHODS Samples were collected from surgically excised tissue from various patients.The content of pro-gastrin-releasing peptide(pro-GRP)in the serum was measured by an electrochemiluminescence immunoassay.The expression patterns of NGAL and MMP-9 and the relationship between NGAL and MMP-9 were examined by quantitative real-time PCR,Western blotting and immunohistochemical analysis.RESULTS In this study,we found that NGAL and MMP-9 can be used as biomarkers for the detection of tubular adenocarcinoma of the colon and that their combination improved diagnostic accuracy.By analyzing the expression of NGAL in tubular adenocarcinoma at different levels,we found that NGAL expression was significantly upregulated in primary tubular adenocarcinoma tissues compared with normal tissues.The upregulation of NGAL expression was strongly correlated with both the degree of differentiation and the disease stage(I–III),indicating that NGAL could serve as a diagnostic biomarker for tubular adenocarcinoma.When using NGAL as a biomarker for diagnosis,the accuracy was similar to that achieved with the widely used biomarker pro-GRP,suggesting that NGAL is reliable.Moreover,the expression of MMP-9 was also strongly correlated with the differentiation stage,demonstrating that MMP-9 could be used as a biomarker to indicate the progression of tubular adenocarcinoma of the colon.More importantly,the combination of NGAL and MMP-9 produced a more accurate diagnosis of tubular adenocarcinoma,and these results were further confirmed by immunohistochemical analysis of tissue sections.CONCLUSION Our study demonstrated that both NGAL and MMP-9 can be used as biomarkers for the diagnosis of colon tubular adenocarcinoma and that the results could be further improved by combining them.

The Differences of Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels between Asphyxiated and Non-Asphyxiated Neonates

Objective: To evaluate the differences of urinary NGAL levels between asphyxiated and non-as- phyxiated neonates. Methods: This was a cross-sectional observational analytic study, including 34 newborns in Dr. Hasan Sadikin Hospital, Bandung, Indonesia. Sample collection was conducted from December 2014 to March 2015. Urine NGAL levels were evaluated using enzyme-linked immunosorbent assays (ELISA) technique. To determine the differences of urinary NGAL levels between asphyxiated and non-asphyxiated group we used Mann-Whitney U test, and to determine the differences of gestational age and birth weight between these two groups we used Fisher’s exact test. Results: Twenty males (60%) and 14 females (40%) neonates participated in the study. From 34 subjects, 17 neonates were diagnosed with asphyxia and 17 neonates without asphyxia. The results showed that urine NGAL levels had significantly increased in asphyxiated neonates. The median urine NGAL level in asphyxiated group is 95% CI: 506.7 (60.0 - 651.7) ng/mL, while the median urine NGAL level in non-asphyxiated group is 95% CI: 6.7 (0.1 - 53.0) ng/mL. Statistically, there were significant urine NGAL levels differences between asphyxiated and non-asphyxi- ated neonates (p < 0.001). There were no differences in gestational age and birth weight between asphyxiated and non-asphyxiated neonates (p > 0.05). Conclusions: Urinary NGAL levels in asphyxiated neonates were significantly higher than those in non-asphyxiated neonates. There were significant differences of urine NGAL levels between the groups.

Evaluation of Reticulocyte Hemoglobin Content and Serum Neutrophil Gelatinase-Associated Lipocalin as Predictive Biomarkers of Anemia in Children on Hemodialysis

Background: Diagnosis of iron deficiency anemia with currently available tests is rendered difficult in hemodialysis patients. The aim: To investigate the role of reticulocyte Hemoglobin Content (CHr) in the diagnosis of iron deficiency anemia in hemodialysis children in comparison to the used traditional markers and assess the impressiveness and the utility of Neutrophil Gelatinase Associated Lipocalin (NGAL) as a novel biomarker of iron status in those patients. Methods: This study investigated CHr in addition to NGAL serum level in the same line with traditional markers for anemia, including: CBC, serum iron, ferritin, total iron-binding capacity (TIBC), and transferrin saturation (TSAT%). Results: It is more significant that CHr content in hemodialysis children is lower than their controls as they are (27.06 ± 2.90) pg and (32.86 ± 3.59) pg, respectively, p = 0.01. There is no significant difference regarding NGAL between the study groups. Significant negative correlation between CHr with ferritin, urea, creatinine, and positively correlated with iron and RBCS. CHr showed a sensitivity of 90% and specificity of 86.67% to detect iron-deficiency anemia with a cut-off value of 27 pg. Conclusion: CHr is superior to ferritin and TSAT % for the early diagnosis of iron deficiency anemia in hemodialysis children;our results do not support NGAL as a marker of anemia in hemodialysis patients.

Correlation between Serum Neutrophil Gelatinase Associated Lipocalin and Burn Severity: A Pilot Study

The severity of an initial burn injury is critical for determining the treatment plan and prognosis of burn patients. Here, we measured serum neutrophil gelatinase-associated lipocalin (NGAL) levels to determine whether NGAL can be used as a biomarker for severity of burn injuries. A study of the demographic, clinical, and laboratory markers for various organ damage was performed at Bestian Burn Center (n = 10 healthy people, n = 31 patients). NGAL and organ damage marker levels were measured in 31 patients with severe burns within 2 - 3 days following their admission to the intensive care unit. Serum NGAL level of the expired patients was 788.5 (685.0 - 998.0) pg/mL, whereas that of the discharged patients was 421.2 (356.2 - 480.6) pg/mL, showing that the initial serum NGAL level can be used to estimate mortality. We also determined the correlation between serum NGAL level and the currently used severity markers (total body surface area burned and abbreviated burn severity index) and confirmed that serum NGAL level could be used as a severity marker. We also found that serum NGAL level was correlated with damage of organs such as the liver, kidney, heart, and respiratory organs in patients with severe burns.

Plasma neutrophil-gelatinase-associated lipocalin and cystatin C could early diagnose contrast-induced acute kidney injury in patients with renal insufficiency undergoing an elective percutaneous coronary intervention

Background Contrast induced acute kidney injury （CIAKI） is an important complication in the use of iodinated contrast media （CM）. Our study was to evaluate the neutrophil gelatinase-associated lipocalin （NGAL） and cystatin C for early diagnosis of CIAKI. Methods The patients with established or suspected coronary artery disease （CAD） with the estimated glomerular filtration rate （eGFR） was more than 30 ml·min^-1·1.73 m^-2 and nor more than 90 ml·min^-1·1.73 m^-2 were continuously enrolled. The blood samples of the first 50 patients were obtained before and at 2, 4, 8, 24 and 48 hours after procedure to identify the time points at which the biomarkers reached peaks and at which the blood samples of the rest of patients were obtained. The plasma NGAL and cystatin C measure used enzyme-linked immunosorbent assay （ELISA） kit. The diagnostic characteristics of absolute and relative increasing NGAL and cystatin C for CIAKI were evaluated. Results Total 311 patients were enrolled, among whom 39 （12.5%） developed CIAKI. Plasma NGAL increased at 2 hours and reached peak at 4 hours after procedure, while plasma cystatin C increased at 2 hours and reached peak at 24 hours after procedure. Thus, we determine rational point of time at 4 hours for NGAL and at 24 hours after procedure for cystatin C, respectively. The plasma NGAL at 4 hours after CM exposure showed largest area under curve （AUC） of 0.662 （95% confidence interval （CI）： 0.565-0.758, P=0.002） with 51.5% sensitivity and 80.6% of specificity. The relative increasing 25% of NGAL showed the best sensitivity and specificity of 0.872 and 0.808, respectively, with maximum Youden index of 0.680, while cystatin C with relative increasing more than 25% had 76.9% of sensitivity and 81.2% of specificity. Combined two biomarkers might get more than 90% of specificity. Conclusions Single measurement of NGAL or cystatin C had poor sensitivity and specificity; however, the relative increasing 25% of NGAL at 4 hours after CM exposure demonstrated higher diagnostic values for CIAKI. Combining relative increasing plasma NGAL with relative increasing plasma cystatin C might perform better for early diagnosis of CIAKI.

Urinary neutrophil gelatinase-associated lipocalin(NGAL)and serum cystatin C measurements for early diagnosis of acute kidney injury in children admitted to PICU

Background Acute kidney injury(AKI)is common in critically ill children with significant mortality and morbidity.Serum creatinine is an insensitive and late biomarker compared to newly proposed AKI biomarkers.Methods Prospective study in pediatric intensive care unit(PICU)over three months to compare between serum cystatin-C(s-Cys-C)and urinary neutrophil gelatinase-associated lipocalin(uNGAL)as AKI biomarkers at multiple time points with pediatric risk,injury,failure,loss,end-stage renal disease(pRIFLE)classification in diagnosing AKI.Results Forty children were recruited.Of these 40 children,22 developed AKI according to pRIFLE criteria.There was no significant difference between AKI and non-AKI in age(P=0.29).Post cardiac surgery,renal insult was the main cause of AKI(27.3%).There was a twofold increased risk of incident AKI in those patients with high baseline uNGAL at PICU admission and almost a fourfold increased risk in patients with high baseline s-Cys-C at PICU admission.uNGAL levels were highly predictive of AKI during the follow-up period[area under the curve(AUC)=0.76,95%confidence interval(CI)0.61-0.92].The cutoff point with the highest correctly classified proportion was 223 ng/mL(≥12 centiles)which correctly predict 80.0%patients with AKI,with a corresponding sensitivity of 72.7%and a specificity of 89.9%.AUC for s-Cys-C was 0.86(95%CI 0.75-0.97),and the highest correctly classified proportion was 1009μg/L(≥13 centiles);75%of patients with AKI,with a corresponding sensitivity of 63.6%and a specificity of 88.9%.Conclusion uNGAL and s-Cys-C predicts AKI early in critically ill children.

Effect of Rhizoma Polygoni Cuspidati and Ramulus Cinnamomi Compatibility on Uric Acid Metabolism and Urinary Neutrophil Gelatinase-Associated Lipocalin and Kidney Injury Molecule-1 in Rats with Hyperuricemia

Objective：To explore the effects of Rhizoma Polygoni Cuspidati and Ramulus Cinnamomicompatibility（PR） on uric acid metabolism and the expression of urinary neutrophil gelatinase-associated lipocalin（NGAL） and kidney injury molecule-1（KIM-1） in rats with hyperuricemia. Methods：Seventy male Sprague Dawley（SD） rats were randomly divided into 7 groups with 10 rats per group, including the normal group, model group, allopurinol group, benzbromarone group and PR groups at 3 doses（3.5, 7, 14 g/kg）. Except the normal group, rats of the other groups were intragastrically administered 100 mg/kg hypoxanthine and 250 mg/kg ethambutol, and subcutaneously injected with 200 mg/kg potassium oxonate. All rats were continuously modeled for 17 days, and gavaged with corresponding drugs. The rats of the normal and model groups were gavaged with saline, once a day, for 2 weeks. The levels of serum uric acid（SUA）, blood urea nitrogen（BUN） and creatinine（Cr） were determined. In addition, the contents of NGAL and KIM-1 in urine and the m RNA and protein expressions of xanthine oxidase（XOD） in liver of hyperuricemia rats were measured by reverse transcription polymerase chain reaction（RT-PCR） and Western blot, respectively. Moreover, the pathological changes of kidney were analyzed by hematoxylin and eosin（HE） stain method. Results：Compared with the normal group, the levels of SUA, BUN, NGAL and KIM-1 and the expressions of hepatic XOD m RNA and protein in the hyperuricemia rats were increased significantly（P〈0.01）. PR significantly decreased the levels of SUA, BUN, NGAL and KIM-1 and down-regulated the m RNA and protein expressions of hepatic XOD（P〈0.05 or P〈0.01）. In addition, the pathological changes of kidney were significantly suppressed by oral administration of PR. Conclusions：PR ameliorated uric acid metabolism and protected renal function, the underlying mechanism was mediated by decreasing the levels of SUA, BUN, NGAL and KIM-1, inhibiting the expression of hepatic XOD and ameliorating the pathological change of kidney.

Urine neutrophil gelatinase-associated lipocalin at SICU admission predicts for cardiac surgery-associated acute kidney injury

Background Acute Kidney Injury （AKI） is a common and serious complication of cardiovascular surgery. There is a need to find biomarkers that are involved in the etiology of cardiac surgery-associated acute kidney injury （CSA-AKI） and have an earlier response to acute kidney injury. The association between urine neutrophil gelatinase-associated lipocalin （NGAL） concentrations and AKI progression is not well established. Methods The prospective-cohort study included 1631 consecutive adult patients undergoing cardiac surgery at Fuwai Hospital between September 2012 and November 2013. AKI defined by Acute Kidney Injury Network （AKIN） criteria with a postoperative increase in plasma creatinine 〉/50% baseline or/〉0.3 mg/dL. Urine NGAL was measured us- ing latex particle-enhanced turbidimetric immunoassay. Associations between Urine NGAL levels and AKI were determined by estimating areas under receiver operating characteristic curves （AUC）. Results A total of 438 （26.9%） patients developed CSA-AKI. And the patients were divided into four groups： 1193 non-AKI patients, 368（22.6%） patients with AKIN stage I AKI, 49（3.0%） with AKIN stage 2 AKI and 21（1.3%） with AKIN stage 3 AKI. urine NGAL concentrations at surgical intensive care unit （SICU） admission were significantly related to AKI severity. The AUCs for urine NGAL were for AKIN stage 1 （0.54±0.02）, AKIN stage 2 （0.67±0.04）, and AKIN stage 3 （0.76±0.06）, respectively. Conclusions Urinary NGAL is associated with CSA-AKI and its progression, indicating their potential use as prognostic markers. Urine NGAL level measured at SICU admission predicts the development of severe AKI after cardiac surgery.

血浆NGAL和血清CysC在糖尿病肾病早期诊断中的临床价值

目的探讨2型糖尿病(T2DM)患者血浆中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和血清胱抑素C(CysC)的改变及其对糖尿病肾病(DN)的诊断价值。方法选择T2DM患者58例,根据尿微量清蛋白/尿肌酐比值(ACR)分为正常清蛋白尿组(ACR<30mg/mmol)和高清蛋白尿组(ACR≥30mg/mmol);另选择40例健康体检者作为对照,测定其血浆NGAL、血清CysC、肾功能、血糖及血脂等水平。结果血浆NGAL和血清CysC水平在对照组、正常清蛋白尿组和高清蛋白尿组中呈逐步增高趋势,差异有统计学意义(P<0.05);Pearson相关分析,血浆NGAL与血清CysC、肌酐(CREA)呈正相关(相关系数分别为0.58、0.43、0.66,P<0.05);血清CysC与CREA、BUN亦呈正相关(相关系数分别为0.73、0.58,P<0.05)。结论 DN患者血浆NGAL与血清CysC水平显著升高,二者呈明显正相关,均与肾损伤程度有关,二者可以作为DN早期无创性诊断指标。

骨髓增殖性肿瘤患者NGAL、VEGF、PC及PS表达水平及意义研究

目的观察骨髓增殖性肿瘤(MPN)患者中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、血管内皮生长因子(VEGF)、血浆蛋白C(PC)及血浆蛋白S(PS)表达水平,并分析其临床意义。方法回顾性选取2019年1月至2021年8月在沧州市中心医院初诊MPN患者40例、MPN治疗后患者40例,以及健康体检者40例为研究对象,分别作为初诊组、治疗后组、对照组。观察3组研究对象、不同临床特征MPN患者的NGAL、VEGF、PC及PS表达水平,分析影响MPN患者的NGAL、VEGF、PC及PS表达水平的因素。结果初诊组、治疗后组的NGAL[(18.34±2.11)、(10.49±1.87)ng/mL]、VEGF[(239.29±10.45)、(151.34±9.13)pg/mL]水平均显著高于对照组[(2.37±0.45)ng/mL、(78.66±8.35)pg/mL],初诊组、治疗后组的PC[(1794.35±142.49)、(2918.21±85.35)ng/mL]、PS[(43424.64±102.41)、(63467.47±125.48)ng/mL]水平均显著低于对照组[(3265.46±72.98)ng/mL、(94253.32±178.23)ng/mL],差异均有统计学意义(P<0.05)。合并血栓、有脾大、血红蛋白<100g/L、血小板<10×10^(9)/L的MPN患者的NGAL、VEGF水平较高,PC、PS水平较低,差异均有统计学意义(P<0.05)。多重线性回归分析结果显示,发现有无血栓和血红蛋白水平均是影响MPN患者NGAL、VEGF、PC及PS水平的因素(P<0.05)。结论MPN患者NGAL、VEGF水平较高,PC、PS水平较低,治疗后会改善,且与患者是否合并血栓、血红蛋白水平相关。

早期糖尿病肾病血清NGAL与致动脉硬化指数的关系

目的观察在早期糖尿病肾病(DN)患者血清中性粒细胞明胶酶相关载脂蛋白(NGAL)水平的变化,探讨NGAL与致动脉硬化指数(AIP)的关系。方法选取尿微量白蛋白/肌酐<300 mg/g的糖尿病患者120例为糖尿病组,根据尿微量白蛋白/肌酐分为正常白蛋白尿组和早期DN组,另选取健康体检者60例作为对照组。检测各组血清甘油三酯(TG)、胆固醇(CHOL)、高密度脂蛋白(HDL)、NGAL、超敏C反应蛋白(hs-CRP)等,并计算致动脉硬化指数;分析3组NGAL、hs-CRP、AIP的变化。按照AIP三分位数将所有研究对象分成低、中、高水平3组,分析其NGAL和hs-CRP的变化。对所有变量进行简单线性相关和多元线性逐步回归分析。结果与对照组比较,正常白蛋白尿组和早期DN组NGAL、hs-CRP、AIP水平明显升高(P<0.001);与正常白蛋白尿组比较,早期DN组NGAL、hs-CRP、AIP水平明显升高(P<0.001)。血清NGAL水平随AIP上升而明显上升(P<0.001)。AIP与hsCRP、NGAL呈正相关(r=0.296,0.313,P<0.05);NGAL、hs-CRP为AIP的独立影响因素。结论血清NGAL是监测糖尿病早期肾损伤的指标。NGAL是一个急性时相反应蛋白,参与了糖尿病肾病动脉粥样硬化的发生发展。

血清FFA、PAPP-A、Kim-1及NGAL对妊娠期糖尿病早期肾功能损伤诊断价值

目的:探究血清游离脂肪酸(FFA)、妊娠相关血浆蛋白A(PAPP-A)、尿肾损伤分子-1(Kim-1)及中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平对妊娠期糖尿病(GDM)早期肾功能损伤诊断价值。方法:选取2019年1月-2020年1月在江油市人民医院产科就诊的124例GDM患者,根据内生肌酐清除率(Ccr)分为肾功能正常组83例和肾功能损伤组41例。另选同期常规孕检健康孕妇60例为对照组。观察3组血清FFA、PAPP-A、Kim-1及NGAL水平,分析其在GDM早期肾功能损伤诊断效能。结果:血清FFA、Kim-1及NGAL水平,肾功能损伤组高于肾功能正常组且均高于对照组,PAPP-A水平肾功能损伤组低于肾功能正常组且均低于对照组(P<0.05)。FFA与Kim-1、NGAL呈正相关(r=0.674、0.712,P<0.01),与PAPP-A呈负相关(r=-0.648,P<0.01);PAPP-A与Kim-1、NGAL呈负相关(r=-0.711、-0.754,P<0.01),Kim-1与NGAL呈正相关(r=0.731,P<0.01)。FFA、PAPP-A、Kim-1及NGAL诊断肾损伤的最佳截断值分别为>1.2mmol/L、≤4.5U/L、≥7.0 ng/ml及>55.9 ug/L,灵敏度分别为74.5%、85.1%、78.4%、87.1%,特异度分别为86.4%、87.2%、95.6%、87.1%,AUC分别为0.840、0.901、0.887及0.891。PAPP-A、Kim-1及NGAL对GDM早期肾功能损伤诊断价值高于FFA。结论:血清FFA、PAPP-A、Kim-1及NGAL有助于GDM患者早期肾功能损伤的临床筛查,尤其是PAPP-A、Kim-1及NGAL灵敏度和特异度较高。

血清学指标联合序贯器官衰竭评估评分对重症急性肾损伤患者预后的预测价值

目的探究血清学指标联合序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分对重症急性肾损伤(acute kidney injury,AKI)患者预后的预测价值。方法回顾性分析2015年12月至2020年12月桐乡市第一人民医院收治的80例重症AKI患者的临床资料,根据28d生存情况将其分为生存组(n=53)和死亡组(n=27)。比较两组患者的临床资料,采用Pearson法分析血浆中性粒细胞明胶酶相关脂质运载蛋白(plasma neutrophil gelatinase-associated lipocalin,pNGAL)水平与胱抑素C(cystatin C,CysC)、血肌酐(serum creatinine,SCr)、SOFA评分的相关性,绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析各参数预测重症AKI患者预后的诊断价值。结果两组患者的性别、年龄、体质量指数、基础疾病、AKI病因、血尿素氮及尿酸水平比较差异均无统计学意义(P>0.05),死亡组患者的pNGAL、CysC、SCr水平及SOFA评分均显著高于生存组(P<0.05);重症AKI患者pNGAL水平与CysC、SCr、SOFA评分均呈正相关(r=0.529、0.531、0.523,P<0.05);pNGAL、CysC、SCr及SOFA评分单独及联合预测重症AKI患者预后的曲线下面积分别为0.776、0.813、0.838、0.837、0.902。结论pNGAL、CysC、SCr及SOFA评分与重症AKI患者的病情严重程度密切相关,上述指标联合检测对重症AKI患者28d内病死率具有较高的预测价值,对合理制定治疗方案及预后评估有一定指导作用。

血浆中性粒细胞明胶酶相关脂质运载蛋白在冠心病病变程度预测中的应用价值

目的探讨血浆中性粒细胞明胶酶相关脂质运载蛋白在冠心病病变程度预测中的应用价值。方法回顾性选取2017年10月至2019年10月上海市闸北中心医院收治的冠心病患者65例,依据疾病类型分为急性冠脉综合征组(n=33)和稳定型心绞痛组(n=32)两组。另选取同期同院收治的因胸闷、胸痛入院、具有正常的冠脉造影或冠脉狭窄在50%以内的患者45例作为对照组,统计分析各组患者的低密度脂蛋白胆固醇、C-反应蛋白水平、Gensini积分、血浆中性粒细胞明胶酶相关脂质运载蛋白水平。结果急性冠脉综合征组患者的血清低密度脂蛋白胆固醇、C反应蛋白、Gensini积分分别为(2.3±0.6)mmol/L、(10.2±1.1)mg/L、(38.1±6.8)分,稳定型心绞痛组分别为(1.7±0.5)mmol/L、(4.2±1.3)mg/L、(20.5±3.8)分,对照组分别为(2.0±0.6)mmol/L、(4.2±1.3)mg/L、(3.1±1.0)分。急性冠脉综合征组患者的血清低密度脂蛋白胆固醇、C反应蛋白水平、Gensini积分均显著高于稳定型心绞痛组和对照组,差异均具有统计学意义(P<0.05);稳定型心绞痛组患者的血清低密度脂蛋白当固醇水平显著低于对照组,Gensini积分显著高于对照组,差异均具有统计学意义(P<0.05)。急性冠脉综合征、稳定型心绞痛组、对照组患者的血浆中性粒细胞明胶酶相关脂质运载蛋白水平分别为(41.7±7.4)ng/ml、(34.1±5.1)ng/ml、(26.9±4.7)ng/ml;急性冠脉综合征组患者的血浆中性粒细胞明胶酶相关脂质运载蛋白水平显著高于稳定型心绞痛组和对照组,稳定型心绞痛组患者的血浆中性粒细胞明胶酶相关脂质运载蛋白水平显著高于对照组,差异均具有统计学意义(P<0.05)。1支病变组、2支病变组、3支病变组患者的血浆中性粒细胞明胶酶相关脂质运载蛋白水平分别为(28.0±4.9)ng/ml、(38.7±6.1)ng/ml、(49.6±7.7)ng/ml;1支病变组患者的血浆中性粒细胞明胶酶相关脂质运载蛋白水平显著低于2支病变组和3支病变组,2支病变组患者的血浆中性粒细胞明胶酶相关脂质运载蛋白水平显著低于3支病变组,差异均具有统计学意义(P<0.05)。结论随着冠心病病变程度的加重,患者的血浆中性粒细胞明胶酶相关脂质运载蛋白水平逐渐升高。血浆中性粒细胞明胶酶相关脂质运载蛋白在冠心病病变程度预测中的应用价值较高。

血浆置换治疗局灶节段性肾小球硬化前后尿液的中性粒细胞明胶酶相关载脂蛋白变化及临床意义

目的分析原发性局灶节段硬化性肾小球肾炎（FSGS）患者血浆置换治疗前后尿液中性粒细胞明胶酶相关载脂蛋白（NGAL）变化的临床意义。方法观察2012年1-12月石家庄肾病医院肾五科经肾活检诊断为FSGS的患者105例,比较血浆置换治疗前、治疗后1周、4周尿液NGAL的差异及同期24 h尿蛋白定量结果。结果治疗1周后与血浆置换治疗前比较,尿NGAL显著下降[（7.2±1.5）μg比（10.2±2.3）μg,P〈0.05],但24 h蛋白定量差异无统计学意义[（2920±1690）mg比（3070±1810）mg,P〉0.05];治疗4周后较血浆置换治疗前,尿NGAL显著下降[（6.2±2.1）μg比（10.2±2.3）μg,P〈0.05],且24 h尿蛋白定量也显著下降[（1430±180）mg比（3070±1810）mg,P〈0.05];血浆置换治疗后4周与治疗后1周比较,尿NGAL结果差异无统计学意义[（6.2±2.1）μg比（7.2±1.5）μg,P〉0.05],而24 h尿蛋白定量显著下降[（1430±180）mg比（2920±1690）mg,P〈0.05]。结论尿液NGAL测定与临床疗效具有一致性,其敏感程度较24 h尿蛋白定量高。

Value of serum NGAL and HE4 content change for diagnosing lung cancer and evaluating disease progression

Objective: To study the value of serum NGAL and HE4 content change for diagnosing non-small cell lung cancer (NSCLC) and evaluating disease progression. Methods: Patients who were diagnosed with NSCLC and underwent surgical resection in the First Affiliated Hospital of Chengdu Medical College between February 2015 and March 2017 were selected as the NSCLC group, and healthy volunteers who received physical examination over the same period were selected as control group. The NGAL and HE4 contents in serum of NSCLC group and control group as well as the expression of proliferation, apoptosis and invasion genes in NSCLC lesion of NSCLC group were detected. Results: Serum NGAL and HE4 levels of NSCLC group were significantly higher than those of control group, serum NGAL and HE4 levels of patients with TNM II and TNM III NSCLC were significantly higher than those of patients with TNM I NSCLC, and serum NGAL and HE4 levels of patients with TNM III NSCLC were significantly higher than those of patients with TNM II NSCLC;c-myc, Survivin, CatL, Vimentin, Slug and Snail mRNA expression in NSCLC lesion were significantly higher than those in adjacent lesion and positively correlated with serum NGAL and HE4 levels while PTEN, LATS1 and E-cadherin mRNA expression were significantly lower than those in adjacent lesion and negatively correlated with serum NGAL and HE4 levels. Conclusion: Abnormally elevated NGAL and HE4 in the serum of NSCLC patients can evaluate the proliferation and invasion of cancer cells to a certain extent.

急性胰腺炎患者血浆中性粒细胞明胶酶相关脂质运载蛋白测定及其临床意义

目的定量检测急性胰腺炎（AP）患者外周血血浆中中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的浓度，并初步探讨其在评估AP严重程度方面的价值。方法选择2011年6月至2012年3月AP患者83例，其中轻症急性胰腺炎（MAP）43例，重症急性胰腺炎（sAP）40例。另选择30名健康体检者作为健康对照组。采集AP患者和健康对照者外周静脉血，离心后取血浆，采用双抗体夹心ELISA法定量检测血浆中NGAL的浓度。组间比较行t检验。血浆NGAL浓度与AP患者临床指标的相关性行Spearman相关检验。用ROc曲线和AUc评价血浆NGAL浓度对SAP的诊断价值。结果AP组血浆NGAI。浓度[（10．30±5．97）nmol／L]高于健康对照组[（1．94±1．35）nmol／L]，差异有统计学意义（t=11．924，P〈0．01）。SAP组血浆NGAL浓度[（14．61士5．28）nmol／L]高于MAP组[（6．27±3．09）nmol／L]和健康对照组，差异均有统计学意义（t=8．677和14．539，P均〈O．01）。AP患者血浆NGAI．浓度与急性生理与慢性健康评估（APAcHE）Ⅱ评分、Ranson评分、急性胰腺炎严重程度床边指数（BIsAP）、CT严重指数（CTSI）、CRP水平、白细胞水平、住院时间呈正相关（r=0．651、0．556、0．514、0．620、0．320、0．458、0．346，P均〈O．05）。以血浆NGAL浓度诊断sAP的ROC曲线的AUC为0．926，95％CI为0．870t0．983。以血浆NGAL浓度≥8．44nmol／L为诊断SAP的临界值时，敏感度为87．5％，特异度为88．9％。结论血浆NGAL浓度与AP患者病情严重程度相关。NGAL有可能成为SAP早期诊断的指标之一。