糖尿病肾病患者尿液 NGAL 蛋白的定性及定量检测比较

目的：明确尿液中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的定性及定量检测在糖尿病肾病早期诊断中的意义。方法将74例糖尿病患者按其24 h 尿微量清蛋白排泄率（UAER）分为正常蛋白尿组26例（DN1组，UAER＜30 mg/24 h），微量蛋白尿组24例（DN2组，UAER 介于30～300 mg/24 h）及大量蛋白尿组24例（DN3组，UAER＞300 mg/24 h），同时建立对照组25例。同时测定各组尿 NGAL 蛋白的活性及水平并比较两种检测结果。结果各组患者尿 NGAL 活性条带均较对照组明显清晰（P ＝0．000），大量蛋白尿组 NGAL 活性较正常蛋白尿组高（P ＜0．05），微量蛋白尿组与正常蛋白尿组比较差异无统计学意义（P ＞0．05）；定量检测则提示大量蛋白尿组 NGAL 水平与其他3组存在区别，大量蛋白尿组 NGAL 排出量高于微量蛋白尿组、正常蛋白尿组及对照组（P ＝0．000），对照组与正常蛋白尿组、微量蛋白尿组三者间两两比较差异无统计学意义（P ＞0．05）。结论对糖尿病肾病患者而言，尿 NGAL 蛋白活性检测比尿微量蛋白排泄率检测及 NGAL 定量检测敏感，有可能成为糖尿病肾病早期诊断的新型指标。

Comparison of qualitative and quantitative detections of urine NGAL in patients with diabetic nephropathy

Objective To ascertain the significance of qualitative and quantitative detections of urine neutrophil gelatinase-associ-ated lipocalin（NGAL）in the early diagnosis of diabetic nephropathy.Methods 74 patients with diabetes mellitus were divided into the normoalbuminuria group（DN1 ,n =26,urinary albumin excretion rate（UAER）〈30 mg/24 h],the microalbuminuria group （DN2 ,n=24,UAER 30-300 mg/24 h）and the macroalbuminuria group（DN3 ,n=24,UAER＆gt;300 mg/24 h）according to the 24 h UAER,and at the same time the control group（n=25）was set up.Both the activity and levels of urine NGAL in the above groups were examined and compared.Results The activity band of urine NGAL in each group were more distinct than that of the control group（P =0.000）.The NGAL activity in the macroalbuminuria group was higher than that in the normoalbuminuria group（P〉0.05）.No difference in the NGAL activity was found between the micro-and normal-albuminuria groups（P〉0.05）;the quantitative detection demonstrated that differences of the NGAL content existing between the macroalbuminuria group and the other three groups had statistical significance（P =0.000）,the urinary NGAL excretion in the macroalbuminuria group was higher than that in the microalbuminuria group,normoalbuminuria group and the control group（P =0.000）;No differences were found between the control group and the normoalbuminuria group and between the control group and the microalbuminuria group（P 〉0.05）.Conclu-sion For the patients with diabetic nephropathy,the activity detection of urine NGAL is more sensitive than UAER and the NGAL quantitative detection and could become a new type index in the early diagnosis of diabetic nephropathy.