不同时间点血中性粒细胞明胶酶相关脂质运载蛋白水平与急性肾损伤程度的关系

目的 探讨不同时间点血中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平与急性肾损伤病变程度的关系。方法 选取200只6周龄Wistar雄性大鼠,按体质量随机分为4组,假手术组仅分离肾门定位肾动脉但不夹闭,其余各组分别夹闭肾动脉30 min、45 min、60 min,制备不同程度肾损伤模型,即轻度损伤组、中度损伤组和重度损伤组,每组以术前、2、6、12及24小时为时间点分为5小组进行血肌酐（Cr）、NGAL水平的测定。结果 大鼠不同程度急性肾损伤造模成功;不同肾损伤程度病理学变化不同;术前、2、6及12小时不同组别Cr水平比较,差异无统计学意义（P>0.05）;24小时不同组别Cr水平比较,差异有统计学意义（P<0.01）,重度损伤组Cr水平高于其余各组（P<0.05）;0、12及24小时不同组别血NGAL水平比较,差异无统计学意义（P>0.05）;2小时不同组别血NGAL水平比较,差异有统计学意义（P<0.05）,中度损伤组血NGAL水平高于假手术组（P<0.05）;重度损伤组血NGAL水平高于假手术组（P<0.01）;6小时不同组别血NGAL水平比较,差异有统计学意义（P<0.05）,重度损伤组血NGAL水平高于假手术组（P<0.01）。结论 NGAL对于急性肾损伤的早期诊断有重要价值,且表达水平与损伤程度有关。

Correlation between blood NGAL levels at various time points and degree of acute kidney injury

Objective To investigate the relationship between the blood levels of neutrophil gelatinase-associated lipocalin (NGAL) at different time points and the degree of acute kidney injury (AKI).Methods 200 six-week-old male Wistar rats were randomly divided into four groups according to their body mass. The rats in the sham operation group were exposed only the renal artery, but the rats in the other 3 groups were exposed and clamped the renal artery for 30 min, 45 min and 60 min, respectively, so as to prepare mild, moderate and severe rat models of renal injury. The serum levels of NGAL and creatinine (Cr) were determined in each group at 0, 2, 6, 12 and 24 hours after the renal injury. Results The AKI rat models in different degree were successfully established and a variety of pathological changes were observed in different degree models. There was no significant difference in the Cr level among the four groups at time points of 0, 2, 6 and 12 hours (P>0.05), but there was significant difference in the Cr level among them at time point of 24 hours (P<0.01), and the Cr level in the severe injury group was the highest (P<0.05). The blood levels of NGAL at time points of 0, 12 and 24 hours were not significantly different among the four groups (P>0.05), but the NGAL level at time point of 2 hours among them was significantly different (P<0.05), and there also were significant difference when the NGAL level in the moderate or severe injury group compared with that in the sham operation group (all P<0.05). Similarly, the NGAL level at time point of 6 hours among them was significantly different (P<0.05), and when compared with the sham operation group, the severe injury group was also significant different (P<0.01). Conclusion The NGAL level would be much valuable for the early diagnosis of AKI and its expression level is associated with the injury degree.