中性粒细胞明胶酶相关脂质运载蛋白在弥散性血管内凝血中的诊断和预后意义。
Diagnostic and prognostic significance of neutrophil gelatinase-associated lipocalin in disseminated intravascular coagulation.
机构信息
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
出版信息
Clin Chim Acta. 2014 Mar 20;430:145-9. doi: 10.1016/j.cca.2014.01.022. Epub 2014 Feb 6.
BACKGROUND
Neutrophil gelatinase-associated lipocalin (NGAL) exists as monomers, homodimers, and NGAL/matrix metalloproteinase-9 (MMP-9) complexes. Circulating neutrophils are activated in ongoing disseminated intravascular coagulation (DIC); therefore, plasma NGAL levels are likely to be increased in DIC. We investigated the diagnostic performance of the plasma NGAL level in predicting acute kidney injury (AKI) in patients with DIC and determined the prognostic value of NGAL.
METHODS
A total of 126 patients with suspected DIC were enrolled. The plasma free NGAL was analyzed with a point-of-care immunoassay. Plasma total NGAL and NGAL/MMP-9 complex levels were measured using commercial kits.
RESULTS
Median free and total NGAL levels were markedly higher in patients with AKI than those without AKI. However, no significant difference in the NGAL/MMP-9 complex level was found between the groups. In patients without AKI, the plasma free and total NGAL levels were significantly higher in those with overt-DIC than in those without overt-DIC. Of note, the free NGAL level showed a significant prognostic value in DIC.
CONCLUSION
Plasma free and total NGAL proved to be powerful markers for AKI in DIC patients and plasma free NGAL also has a prognostic relevance in DIC patients without AKI.
背景
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）以单体、同源二聚体和 NGAL/基质金属蛋白酶-9（MMP-9）复合物的形式存在。循环中性粒细胞在持续弥散性血管内凝血（DIC）中被激活；因此，DIC 患者的血浆 NGAL 水平可能升高。我们研究了血浆 NGAL 水平对预测 DIC 患者急性肾损伤（AKI）的诊断性能，并确定了 NGAL 的预后价值。
方法
共纳入 126 例疑似 DIC 的患者。采用即时检验免疫分析法分析血浆游离 NGAL。使用商业试剂盒测量血浆总 NGAL 和 NGAL/MMP-9 复合物水平。
结果
AKI 患者的游离和总 NGAL 水平中位数明显高于无 AKI 患者。然而，两组之间的 NGAL/MMP-9 复合物水平没有显著差异。在无 AKI 的患者中，显性 DIC 患者的血浆游离和总 NGAL 水平明显高于无显性 DIC 患者。值得注意的是，游离 NGAL 水平在 DIC 患者中具有显著的预后价值。
结论
血浆游离和总 NGAL 可作为 DIC 患者 AKI 的有力标志物，血浆游离 NGAL 对无 AKI 的 DIC 患者也具有预后相关性。
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