尿中性粒细胞明胶酶相关载脂蛋白作为儿童严重狼疮性肾炎的标志物。

Urinary neutrophil gelatinase-associated lipocalin as a marker of severe lupus nephritis in children.

机构信息

Pediatric Nephrology Unit, Mansoura University Children's Hospital, Egypt.

出版信息

Lupus. 2013 Apr;22(5):486-91. doi: 10.1177/0961203313479419.

DOI:10.1177/0961203313479419

PMID:23554037

Abstract

INTRODUCTION

More than 60% of children with systemic lupus erythematosus (SLE) develop lupus nephritis (LN). Neutrophil gelatinase-associated lipocalin (NGAL) is a protein secreted by leukocytes during inflammation and is overexpressed in the kidneys following ischemic and nephrotoxic damage.

AIM

To study urinary and serum NGAL in children with SLE and investigate their possible role as markers of renal involvement. Methods Urinary and serum levels of NGAL were assessed in 33 children with active SLE (22 with and 11 without LN) and compared to 15 matched controls.

RESULTS

Children with SLE had elevated urinary NGAL as compared to controls (P<0.001). Levels of urinary NGAL were higher in patients with LN than those without LN (P<0.001). In patients with LN, serum levels of NGAL were not significantly different from controls (P=0.4) and urinary NGAL correlated with the renal score of the Systemic Lupus Erythematosus Disease Activity Index (r=0.5, P=0.02) but not with serum NGAL (P=0.5). Urinary NGAL was significantly predictive of class III and IV LN (P=0.005) with 91% sensitivity and 70% specificity to levels ≥ 10.07 ng/mg creatinine. Conclusions Urinary NGAL is a sensitive marker of proliferative nephritis in juvenile SLE.

摘要

简介

超过 60%的系统性红斑狼疮 (SLE) 患儿会发展为狼疮性肾炎 (LN)。中性粒细胞明胶酶相关脂质运载蛋白 (NGAL) 是白细胞在炎症过程中分泌的一种蛋白质，在缺血和肾毒性损伤后肾脏中过度表达。

目的

研究儿童 SLE 患者的尿液和血清 NGAL，并探讨其作为肾脏受累标志物的可能作用。方法：评估了 33 例活动期 SLE 患儿（22 例伴 LN，11 例无 LN）的尿液和血清 NGAL 水平，并与 15 名匹配的对照者进行比较。

结果

与对照组相比，SLE 患儿的尿液 NGAL 升高（P<0.001）。有 LN 的患儿尿液 NGAL 水平高于无 LN 的患儿（P<0.001）。在有 LN 的患儿中，血清 NGAL 水平与对照组无显著差异（P=0.4），且尿液 NGAL 与系统性红斑狼疮疾病活动指数（SLEDAI）的肾脏评分呈正相关（r=0.5，P=0.02），与血清 NGAL 无关（P=0.5）。尿液 NGAL 对 III 级和 IV 级 LN 有显著预测作用（P=0.005），其水平≥10.07ng/mg 肌酐时，诊断敏感度为 91%，特异度为 70%。结论：尿液 NGAL 是儿童 SLE 增殖性肾炎的敏感标志物。