本文選題：中性粒細胞明膠酶相關脂質運載蛋白 + 狼瘡性腎炎��； 參考：《中南大學》2014年碩士論文

【摘要】：目的 分析中性粒細胞明膠酶相關脂質運載蛋白(NGAL)在系統(tǒng)性紅斑狼瘡(SLE)腎臟病變中的意義,探討血清及尿液NGAL (pNGAL及uNGAL)水平與狼瘡性腎炎(LN)活動性及病理分型之間的關系。 方法 1.收集104例SLE患者(包括63例LN患者及41例非腎炎SLE患者)及60例對照者(包括非SLE的其他自身免疫性疾病和正常對照者各30例)的血液、尿液標本,用膠乳增強免疫比濁法分別測定pNGAL和iNGAL的表達水平。 2.根據腎臟SLEDAI評分,將LN患者分為活動期LN (n=41)和靜止期LN (n=22),測定pNGAL和uNGAL的表達水平。同時收集LN患者的臨床及實驗室資料。據測得的uNGAL建立ROC曲線,分析uNGAL對診斷LN活動性的敏感性和特異性。 3.將LN患者按腎活檢的結果分為不同病理類型的LN,比較不同病理類型LN的pNGAL和uNGAL表達水平的差異。 結果 1.SLE患者的pNGAL與uNGAL水平都高于對照組(P0.01)；與非腎炎SLE患者相比,LN患者的pNGAL與uNGAL水平均顯著升高,差異有統(tǒng)計學意義(P0.05,P0.01)； 2.活動期LN患者與靜止期LN患者相比,pNGAL水平無明顯差異(216.05±133.67ng/mL vs172.75±91.68ng/mL;而uNGAL在活動期LN患者尿液中的水平明顯高于靜止期LN患者(0.76±0.40ng/mg Cr vs0.45±0.29ng/mg Cr, P0.01); 3.LN患者的pNGAL水平與SLEDAI評分之間均無明顯的相關性；uNGAL水平與腎臟SLEDAI評分(r=0.364,P0.01)之間呈正相關,評分值越高,uNGAL的結果就越大； 4. uNGAL的ROC曲線截值點為0.585ng/mg Cr,此時的敏感性和特異性分別為70.73%和77.27%(P0.01)。ROC曲線下面積為0.756； 5.不同病理分型LN患者間的pNGAL水平無明顯差異(P0.05)；Ⅲ型和Ⅳ型LN患者的uNGAL水平雖較其他組高,但差異無統(tǒng)計學意義(P0.05)；增殖型和膜型LN患者之間的pNGAL、 uNGAL水平均無明顯差異(P0.05)。 結論 1.SLE患者發(fā)生腎臟病變時,其pNGAL、uNGAL的濃度都會增高； 2. pNGAL不能作為判斷LN活動性的標志物,uNGAL有可能成為一種新的反映LN活動性的可靠標志物； 3.不同病理分型LN患者的pNGAL、uNGAL水平無差別,兩者均不能作為增殖型LN的標志物。
[Abstract]:Objective to investigate the significance of neutrophil gelatinase-associated lipid carrier protein (NGAL) in renal lesions of systemic lupus erythematosus (SLE). To investigate the relationship between serum and urine NGAL (pNGAL and uNGAL), lupus nephritis (LN) activity and pathological classification. Method 1. Blood and urine samples were collected from 104 SLE patients (including 63 LN patients and 41 non-glomerulonephritis SLE patients) and 60 controls (including 30 non-SLE patients with other autoimmune diseases and 30 normal controls). The expression levels of pNGAL and iNGAL were determined by latex enhanced immunoturbidimetry. 2. According to the SLEDAI score of kidney, the patients with LN were divided into active LN (nong41) and resting LN (nong22). The expression of pNGAL and uNGAL were measured. The clinical and laboratory data of LN patients were also collected. The ROC curve was established to analyze the sensitivity and specificity of uNGAL in the diagnosis of LN activity. According to the results of renal biopsy, LN patients were divided into different types of LNs, and the expression levels of pNGAL and uNGAL in LN were compared. Results 1. The levels of pNGAL and uNGAL in SLE patients were higher than those in control group (P0.01), and the levels of pNGAL and uNGAL in LN patients were significantly higher than those in non-glomerulonephritis SLE patients (P0.05, P0.01). There was no significant difference between active LN patients and rest LN patients (216.05 鹵133.67ng / mL vs172.75 鹵91.68ng / mL), but the level of uNGAL in the urine of active LN patients was significantly higher than that of rest LN patients (0.76 鹵0.40ng/mg Cr vs0.45 鹵0.29ng/mg Cr0.01). 3. The level of pNGAL in LN patients and SLEDAI score was higher than that in inactive LN patients (P0.01). There was no significant correlation between them. There was a positive correlation between the level of uNGAL and the SLEDAI score of kidney (r = 0.364, P 0.01), and the higher the score was, the greater the result of uNGAL was. 4. The cut point of ROC curve of uNGAL was 0.585ng/mg Cr.The sensitivity and specificity of the curve were 70.73% and 77.27% (P0.01) .ROC curve area was 0.756; 5. There was no significant difference in the level of pNGAL between LN patients with different pathological types (P0.05); the level of uNGAL in type 鈪，

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