[1]杨渝伟,陈小红,胡 冬,等.血清中性粒细胞明胶酶相关脂质运载蛋白水平与卒中发生及患者肾功能损害的关系[J].现代检验医学杂志,2018,33(02):23-27.[doi:10.3969/j.issn.1671-7414.2018.02.001]
　YANG Yu-wei,CHEN Xiao-hong,HU Dong,et al.Relationship of Serum Neutrophil Gelatinase-associated Lipocalin Levels with Stroke Attack and Renal Dysfunction in Patients[J].Journal of Modern Laboratory Medicine,2018,33(02):23-27.[doi:10.3969/j.issn.1671-7414.2018.02.001]
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血清中性粒细胞明胶酶相关脂质运载蛋白水平与卒中发生及患者肾功能损害的关系()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第33卷
期数:
2018年02期
页码:
23-27
栏目:
论著
出版日期:
2018-04-05

文章信息/Info

Title:
Relationship of Serum Neutrophil Gelatinase-associated Lipocalin Levels with Stroke Attack and Renal Dysfunction in Patients
文章编号:
1671-7414(2018)02-023-05
作者:
杨渝伟; 陈小红; 胡 冬; 余 琳; 俸家富
绵阳市中心医院检验科,四川绵阳 621000
Author(s):
YANG Yu-wei; CHEN Xiao-hong; HU Dong; YU Lin; FENG Jia-fu
Department of Laboratory Medicine,Mianyang Central Hospital,Sichuan Mianyang 621000,China
关键词:
脑卒中;  中性粒细胞明胶酶相关脂质运载蛋白;  肾功能损害;  相关性
分类号:
R743; R446.112
DOI:
10.3969/j.issn.1671-7414.2018.02.001
文献标志码:
A
摘要:
目的 探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)与脑卒中发生及患者肾功能损害的关系。方法 随机选择首诊出血性卒中(HS)患者63例、缺血性卒中(IS)患者233例以及门诊健康受试者293例,记录其年龄、性别以及高血压、糖尿病、冠心病和高尿酸血症病史,并于入院次日或体检时检测其血清肾脏标志物(NGAL,Cr,Urea,Cys C和eGFR)水平,按照KDIGO指南标准将所有受试者分为AKI组、CKD组、一过性或无肾损害组以及对照组,代表其肾功能损害程度,分析上述各指标与HS和IS患者卒中发生及其肾功能损害的关系。结果 HS和IS患者NGAL血清水平中值为160.0 μg/L和142.9 μg/L,其差异无统计学意义(Z=2.332,P>0.05),但均高于健康对照(Z=12.621,9.189,均P<0.05); AKI组、CKD组、一过性或无肾损害组和对照组NGAL血清水平中值分别为375.3,228.6,141.6和103.8 μg/L,相互之间差异均有统计学意义(Z=3.661 ～ 11.237,均P<0.05)。NGAL血清水平与HS发生(rp=0.423,P<0.001)、IS发生(rp=0.231,P<0.001)及HS和IS患者肾功能损害(rp=0.429,0.289,均P<0.001)均呈正相关,其偏相关系数在HS发生中仅低于高血压病史率,在IS发生中仅低于冠心病和糖尿病病史率,但在HS和IS患者肾功能损害中均最高。NGAL以其血清水平评估HS和IS发生,作用有限(OR=1.044和1.028,均P<0.001),但以异常检出来评估则作用明显(OR=27.841和15.411,均P<0.001)。结论 NGAL水平增高可能是卒中发生的危险因素,提示肾损伤或肾功能不全可能与卒中发生相关,卒中防治宜重视患者NGAL的改变。
Abstract:
Abstract:Objective To explore the correlations of neutrophil gelatinase-associated lipocalin(NGAL)with cerebral stroke attack and renal dysfunction of patients.Methods 63 patients with first-diagnosed hemorrhagic stroke(HS),233 patients with first-diagnosed ischemic stroke(IS)and 293 healthy controls were randomly selected.Their age,genderand clinical history of hypertension,diabetes,coronary heart disease and hyperuricemia were recorded at admission,and their serum levels of kidney function/injury biomarkers(NGAL,Cr,Urea,CysC and eGFR)were measured at the next day.According to KDIGO guidelines standards,all subjects were divided into four groups on behalf of their renal damage degree:AKI,CKD,transient or no kidney injury,and control group.And then,the relations of these indicators with stroke attack and renal function of HS and IS patients were analyzed.Results The medians of serum NGAL levels in the patients with HS and ISwere 160.0 and 142.9 μg/L,their difference had no statistical significance(Z=2.332,P>0.05),but were higher than healthy controls(Z=12.621,9.189,all P<0.05).The levels of serum NGAL in AKI,CKD,transient or no renal dysfunction,and control groups were 375.3,228.6,141.6 and 103.8 μg/L respectively,which had statistically significant differences between each other(Z=3.661～11.237,all P<0.05).NGAL level was positively related to HS attack(rp=0.423,P<0.001),IS attack(rp=0.231,P<0.001)and renal dysfunction in both HS and IS patients(rp=0.429, 0.289,allP<0.001).Its partial correlation coefficient was only lower than hypertension within HS stroke attack,and lower than coronary heart disease and diabeteswithin IS stroke attack,but the highest within renal function of either HS or IS patients.For assessing HS and IS attack,NGAL levels play a limited role(OR=1.044,0.974,all P<0.001),in contrary to NGAL abnormity(OR=27.841,15.411,all P<0.001).Conclusion Elevated NGAL levelsmay be a risk factor for stroke,suggesting that kidney injury or renal dysfunction may be associated with stroke,and the prevention and treatment of stroke should pay attention to the change of NGAL.

参考文献/References:

[1] Abajobir AA,Abate KH,Abbafati C,et al.Global,regional,and national disability-adjusted life-years(DALYs)for 333 diseases and injuries and healthy life expectancy(HALE)for 195 countries and territories,1990～2016:a systematic analysis for the Global Burden of Disease Study 2016[J].Lancet,2017,390(10100):1260-1344.
[2] Storhaug HM,Norvik JV,Toft I,et al.Uric acid is a risk factor for ischemic stroke and all-cause mortality in the general population: a gender specific analysis from the Tromso Study[J].BMC Cardiovasc Disord,2013,13(1):115.
[3] 国钰梅,马 龙,包成月,等.急性缺血性脑卒中患者尿酸水平与出院结局的关联研究[J].现代检验医学杂志,2015,30(3):17-20. Guo YM,Ma L,Bao CY,et al.Relationship between uric acid levels in patients with acute ischemic stroke and discharged outcome[J].Journal of Modern Laboratory Medicine,2015,30(3):17-20.
[4] Hayden D,McCarthy C,Akijian L,et al.Renal dysfunction and chronic kidney disease in ischemic stroke and transient ischemic attack: A population-based study[J].Int J Stroke,2017,12(7):761-769.
[5] Carr SJ,Wang X,Olavarria VV,et al.Influence of renal impairment on outcome for thrombolysis-treated acute ischemic stroke: ENCHANTED(enhanced control of hypertension and thrombolysis stroke study)post hoc analysis[J].Stroke,2017,48(9):2605-2609.
[6] Makin SD,Cook FA,Dennis MS,et al.Cerebral small vessel disease and renal function:systematic review and meta-analysis[J].Cerebrovasc Dis,2015,39(1):39-52.
[7] Jauch EC,Saver JL,Adams HP J,et al.Guidelines for the early management of patients with acute ischemic stroke:a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J].Stroke,2013,44(3):870-947.
[8] Hemphill JC,Greenberg SM,Anderson CS,et al.Guidelines for the management of spontaneous intracerebral hemorrhage:A guideline for healthcare professionals from the American Heart Association/American Stroke Association[J].Stroke,2015,46(7):2032-2060.
[9] Kellum JA,Lameire N,KDIGO AKI guideline work group.Diagnosis,evaluation,and management of acute kidney injury:a KDIGO summary(Part 1)[J].CritCare,2013,17(1):204.
[10] Stevens PE, Levin A, Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members.Evaluation and management of chronic kidney disease:synopsis of the kidney disease:improving global outcomes 2012 clinical practice guideline[J].Ann Intern Med,2013,158(11):825-830.
[11] Feng JF,Qiu L,Zhang L,et al.Multicenter study of creatinine-and/orcystatin C-based equations for estimation of glomerular filtration rates in Chinese patients with chronic kidney disease[J]. PLoS One,2013,8(3):e57240.
[12] Fabbian F,Gallerani M, Pala M,et al.Association between in hospitalmortality and renal dysfunction in 186 219 patients hospitalized for acute stroke in the Emilia-romagna region of Italy[J].Angiology,2014,65(10):906-910.
[13] Banerjee A,Fauchier L,Vourc HP,et al.Renal impairment and ischemic stroke risk assessment in patients with atrial fibrillation:the Loire Valley Atrial Fibrillation Project[J].J Am Coll Cardiol,2013,61(20):2079-2087.
[14] Sandsmark DK,Messé SR,Zhang XM,et al.Proteinuria,but not eGFR,predicts stroke risk in chronic kidney disease:chronic renal insufficiency cohort study[J].Stroke,2015,46(8):2075-2080.
[15] Martinez Ana-Isabel C,Weinh(¨overa)upl K,Lee Wing-Kee,et al.Biochemical and structural characterization of the interaction between the siderocalin NGAL/LCN2(Neutrophil Gelatinase-associated Lipocalin/Lipocalin 2)and theN-terminal domain of its endocytic receptor SLC22A17[J].J Biol Chem,2016,291(6):2917-2930.
[16] Segal HC,Burgess AI,Poole DL,et al.Population-based study of bloodbiomarkers in prediction of subacute recurrent stroke[J].Stroke,2014,45(10):2912-2917.
[17] Greisenegger S, Segal HC, Burgess AI,et al.Bio-markers and mortality after TIA and minor ischemic stroke: population-based study[J].Stroke,2015,46(3):659-666.
[18] Ronco C,Legrand M,Goldstein SL,et al.Neutro-phil gelatinase-associated lipocalin: ready for routine clinical use? An international perspective[J].Blood Purif,2014,37(4):271-285.

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备注/Memo

备注/Memo:
基金项目:国家重点基础研究发展(973)计划子课题(2015CB755400); 四川省科技厅科技支撑项目(2015SZ0117)。 作者简介:杨渝伟(1972-),男,本科,副主任技师,主要从事临床检验诊断学工作和研究,E-mail:yyw318@vip.163.com。 通讯作者:俸家富,男,主任技师,硕士研究生导师,E-mail:jiafufeng@aliyun.com。
更新日期/Last Update: 2018-04-16