摘要
目的探讨尿液中肾损伤分子-1(KIM-1)和中性粒细胞明胶酶相关载脂蛋白(NGAL)对高血压肾损害的诊断价值。方法选择原发性高血压患者68例,根据尿白蛋白/肌酐(Cr)比值(UACR)分为正常白蛋白尿组(NA组)19例、微量白蛋白尿组(MA组)24例、临床蛋白尿组(CA组)22例;同期选取14例健康人做正常对照(对照组)。检测血Cr、尿白蛋白、尿Cr,计算UACR;根据MDRD公式计算肾小球滤过率(e GFR);监测血压,计算平均动脉压(MAP);采用ELISA法检测各组尿KIM-1和NGAL,尿NGAL和KIM-1的检测结果除以尿Cr作为最后结果,以纠正尿液浓度对结果测定的影响。结果高血压各组的e GFR、MAP随蛋白尿增加而逐渐升高,组间比较差异均有统计学意义(P<0.05),但NA组e GFR与对照组比较差异无统计学意义;尿NGAL/Cr和尿KIM-1/Cr随着蛋白尿的增加而逐渐升高,各组间比较差异均有统计学意义(P<0.05);在相关性分析中,尿NGAL/Cr与UACR和MAP呈正相关,与e GFR呈负相关,而尿KIM-1/Cr与UACR呈正相关,与e GFR呈负相关,与MAP无关。结论尿KIM-1在高血压蛋白尿出现之前的早期肾损伤具有一定的预测价值,而NGAL不但可作为早期高血压肾损害的诊断指标,而且还能协助评估血压控制情况,推测其对高血压其他脏器损害也有预测价值。
Objective To investigate the expression and significance of urine kidney injury molecule -1 （KIM -1） and neutrophil gelatinases associated lipocalin （NGAL） in hypertensive renal damage with different degree of albumi -nuria.Methods Sixty -eight patients with primary hypertension were selected .According to the urinary albumin /creati-nine ratio （ACR）, they were divided into normal albuminuria group （NA, n =19）, microalbuminuria group （MA, n =24）, and clinical albuminuria group （CA, n =22）.Fourteen healthy persons were enrolled as normal controls .Serum creatinine, urine creatinine and urine albumin were recorded for calculation of ACR .According to MDRD formula, GFR was also calculated.Blood pressure was monitored and the mean arterial pressure （MAP） was calculate.By ELISA meth-od, urine NGAL and KIM -1 were assessed, and the test results were presented with urine NGAL and KIM -1 divided by urine creatinine as the final results .Results The levels of eGFR and MAP were significantly increased with the increase of proteinuria in each hypertension groups , there was statistical significance among the 3 groups （P ＆lt;0.05）; but there was no significant difference in eGFR between NA group and normal control group .Urine NGAL/Cr and KIM -1 /Cr were increased with the increase of proteinuria in each hypertension groups , there was statistical significance among the 3 groups （P ＆lt;0.05）.In correlation analysis, the urine NGAL /Cr was positively correlated with ACR and MAP, negatively correla-ted with eGFR; the urine KIM -1/Cr was positively correlated with ACR and negatively correlated with eGFR .Conclu-sion The urine NGAL and KIM -1 may be useful to assess early hypertensive kidney injury prior to microalbuminuria . Moreover, NGAL can evaluate the blood pressure control , with predictive value on the hypertension -induced damage of other organs.
出处
《广东医学》
CAS
北大核心
2015年第5期705-708,共4页
Guangdong Medical Journal
基金
江西省科技计划项目(编号:20111BBG70017)
