Serebryakov A A, Miroshnikov V M, Kokhanov A V, Dogadina A O, Mehdiyev K N
Clinical Hospital, No. 3, Astrakhan, Russia.
Astrakhan State Medical University, Ministry of Health of the Russian Federation, Astrakhan, Russia.
Urologiia. 2023 Mar(1):28-33.
To evaluate the role of lactoferrin and lactoferricin in blood serum and urine in patients with an attack of renal colic against the background of urolithiasis and pyelonephritis.
We examined 149 patients admitted to the urological department of the City Clinical Hospital No. 3 of Astrakhan, according to emergency indications, with an attack of renal colic. Along with standard clinical, laboratory and instrumental research methods (general blood count, biochemical blood test, urinalysis, kidney ultrasonography), the concentration of CRP and lactoferrin was measured in all patients in the blood and urine using a set of reagents for ELISA (Lactoferrin "Vector-Best" Novosibirsk city). The sensitivity of the test for CRP and LF was 3-5 g/ml and 5 ng/ml, respectively. Studies of all collected material for lactoferricin were carried out deferred in the laboratory of the Astrakhan State Medical University. Based on the results of clinical and instrumental studies, patients admitted with an attack of renal colic were retrospectively divided into three groups: the first group included 38 patients with urolithiasis. The second group included 64 patients with obstructive pyelonephritis, and the third group included 47 patients hospitalized with characteristic signs of primary non-obstructive pyelonephritis. The groups were matched by sex and age. Blood and urine samples from 25 donors served as controls.
When comparing a group of patients with urolithiasis with a group of patients with non-obstructive and obstructive pyelonephritis, highly significant differences (p<0.0001) were found in LF, LFC, CRP and the number of leukocytes in the blood and urine sediment. In urine, according to the results of ROC-analysis in couples with urolithiasis without pyelonephritis in comparison with obstructive pyelonephritis, the most significant differences were established for all four parameters studied: for LF (AUC=0.823), for LFC (AUC=0.832), for CRP (AUC=0.829 ) and the number of leukocytes in the urine sediment (AUC=0.780).
In blood and urine in patients with urolithiasis and pyelonephritis, the effects of the bactericidal peptide LPC were compared with the levels in biological f luids of CRP, LF, and the number of leukocytes. The greatest diagnostic value of all four studied indicators was found in urine, and not in serum. ROC-analysis confirmed a more significant effect of the studied parameters on pyelonephritis than on urolithiasis. The level of lactoferrin and CRP in patients at admission correlates with the number of leukocytes in the blood and urine sediment and with the degree of inflammation in the body. And the level of LFC peptide in the urine reflects the degree of infection of the urinary tract.
A comparative study of tests for Lf and LFC in blood serum and urine in patients admitted to a urological hospital with an attack of renal colic was carried out. Determining the concentration of lactoferricin in the urine is an informative indicator. Thus, lactoferrin and its hydrolysis product lactoferricin reflect different aspects of the infectious and inflammatory process in pyelonephritis.
评估乳铁蛋白和乳铁素在尿路结石和肾盂肾炎背景下肾绞痛发作患者血清和尿液中的作用。
我们对阿斯特拉罕市第3城市临床医院泌尿外科收治的149例因紧急指征而发作肾绞痛的患者进行了检查。除了标准的临床、实验室和器械检查方法（全血细胞计数、血液生化检查、尿液分析、肾脏超声检查）外，还使用一套用于酶联免疫吸附测定（ELISA）的试剂（新西伯利亚市“Vector - Best”乳铁蛋白）对所有患者的血液和尿液中CRP和乳铁蛋白的浓度进行了测量。CRP和LF检测的灵敏度分别为3 - 5μg/ml和5ng/ml。所有收集的用于乳铁素研究的材料均在阿斯特拉罕国立医科大学实验室进行延期研究。根据临床和器械检查结果，将因肾绞痛发作入院的患者回顾性分为三组：第一组包括38例尿路结石患者。第二组包括64例梗阻性肾盂肾炎患者，第三组包括47例以原发性非梗阻性肾盂肾炎特征性体征入院的患者。各组在性别和年龄上匹配。25名献血者的血液和尿液样本作为对照。
将尿路结石患者组与非梗阻性和梗阻性肾盂肾炎患者组进行比较时，发现血液和尿液沉渣中的LF、LFC、CRP和白细胞数量存在极显著差异（p<0.0001）。在尿液中，根据ROC分析结果，在无肾盂肾炎的尿路结石患者与梗阻性肾盂肾炎患者的配对比较中，所研究的所有四个参数均存在最显著差异：LF（AUC = 0.823）、LFC（AUC = 0.832）、CRP（AUC = 0.829）以及尿液沉渣中的白细胞数量（AUC = 0.780）。
在尿路结石和肾盂肾炎患者的血液和尿液中，将杀菌肽LPC的作用与CRP、LF的生物体液水平以及白细胞数量进行了比较。所有四个研究指标中最大的诊断价值在尿液中，而非血清中。ROC分析证实所研究参数对肾盂肾炎的影响比对尿路结石的影响更显著。入院时患者的乳铁蛋白和CRP水平与血液和尿液沉渣中的白细胞数量以及体内炎症程度相关。而尿液中LFC肽的水平反映了尿路的感染程度。
对因肾绞痛发作入住泌尿外科医院的患者血清和尿液中的Lf和LFC检测进行了比较研究。测定尿液中乳铁素的浓度是一个有信息量的指标。因此，乳铁蛋白及其水解产物乳铁素反映了肾盂肾炎感染和炎症过程的不同方面。
