·糖尿病性肾脏疾病·<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

曾健英  童俊容  何凤  罗正茂  张虹  张建林  王寅

作者单位：510010广州，广州军区广州总医院干部病房二科（曾健英）；肾内科（童俊容、何凤、罗正茂、张虹、张建林、王寅）

通讯作者：童俊容

【摘要】  目的  探讨糖尿病肾病（DN）患者血清和尿液中性粒细胞明胶酶相关载脂蛋白(NGAL)的改变及其临床意义。  方法  选择2型糖尿病(T2DM)患者57例，其中正常白蛋白尿组（NUAlb）16例、微量白蛋白尿组（MUAlb）19例、大量白蛋白尿组（CUAlb）22例；对照组（Con）17例。应用ELISA法检测血清和尿液中NGAL的浓度，并分析血清和尿液中NGAL的水平与肾小球滤过率（GFR）之间的相关关系。另检测尿素氮（BUN）、血肌酐(Scr)、尿白蛋白排泄率（UAER）等指标。  结果  （1）糖尿病患者血清NGAL（sNGAL）和尿液NGAL（uNGAL）浓度均较对照组显著升高（P均<0.01），其中CUAlb组患者的sNGAL及uNGAL浓度达到最高，与肾损害的严重程度相一致。（2）Pearson相关分析：糖尿病患者sNGAL和uNGAL的水平均与GFR存在负相关（相关系数分别为r=0.862，P<0.01；r=0.802，P<0.01）。  结论  NGAL可能在DN的病理生理学方面起重要作用，检测血清和尿液NGAL浓度可能成为DN患者无创并有效的检测手段。

【关键词】中性粒细胞明胶酶相关载脂蛋白；糖尿病肾病

doi:10.3969/j.issn.1006-6187.2011.01.007

The role of neutrophil gelatinase-associated lipocalin in early diagnosing the diabetic nephropathy

ZENG Jian-ying, TONG Jun-rong, HE Feng, et al . Department of Nephrology, <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />Guangzhou Army GeneralHospital,Guangzhou 510010, China

Corresponding author:TONG Jun-rong

【Abstract】  Objective  To explore the role of serum and urinary neutrophil gelatinase-associated lipocalin(NGAL) in early diagnosing diabetic nephropathy in T2DM．  Methods  The study subjects included 57 type 2 diabetic patients with normoalbuminuria (NUAlb, n=16), microalbuminuria (MUAlb, n=19), clinical albuminuria (CUAlb, n=22) and 17 healthy subjects as controls. NGAL was measured in serum and urine using a commercially available ELISA kit. Blood urea nitrogen (BUN), serum creatinine (Scr) and urinary albumin excretion rate (UAER) were measured.  Results  NGAL showed a gradually increased levels in serum from control to NUAlb, MUAlb and CUAlb (52 vs 226 vs 281 vs 886 ng/ml) and in urine (6.7 vs 48.9 vs 98.6 vs 252.6 ng/ml) (all P＜0.05: intergroup comparison). A significant negative relationships (all P＜0.05) of sNGAL and uNGAL with GFR were found.  Conclusions  NGAL might play an important role in the pathophysiology of diabetic nephropathy, and NGAL measurement probably become a useful and noninvasive tool for the evaluation of renal involvement in patients of diabetic nephropathy.

【Key words】Neutrophil gelatinase-associated lipocalin；Diabetic nephropathy