中性粒细胞明胶酶相关脂质运载蛋白在妊娠期高血压疾病中的表达及意义

妊娠期高血压疾病(PIH)的发病机制尚不明确,目前倾向于内皮细胞激活和损伤的一元化学说,其中肾脏损害导致的蛋白尿是评价PIH严重程度较客观的指标。中性粒细胞明胶酶相关脂质运载蛋白(NGAL)是一种新发现的脂质运载蛋白(lipocalin),已有研究证实,NGAL与急慢性     

中性粒细胞明胶酶相关脂质运载蛋白在妊娠期糖尿病患者中的表达及意义

目的:探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在妊娠期糖尿病(GDM)患者血清、脐血及胎盘组织中的表达及其与新生儿体重的相关性。方法:选取2017年6月至2017年11月于河北省人民医院产科行剖宫产术的GDM患者49例、正常妊娠(NGT组)孕妇39例。ELISA法测定母血、脐血血清NGAL水平,RT-PCR及Western blot法测定胎盘组织中NGAL mRNA及其蛋白表达。结果:GDM组母血、脐血血清NGAL水平均高于NGT组,胎盘组织中NGAL mRNA和蛋白表达量高于NGT组,两组比较差异有统计学意义(P0.01)。NGT组和GDM组孕妇血清NGAL水平与脐血均呈正相关(r=0.399,P=0.012;r=0.349,P=0.014);GDM组孕妇血清NGAL水平与胎盘组织NGAL mRNA(r=0.848,P=0.008)、蛋白(r=0.636,P=0.011)及新生儿体重(r=0.363,P=0.014)、胰岛素抵抗指数(r=0.312,P=0.044)均呈正相关。结论:GDM患者外周血NGAL水平的增加主要可能源于胎盘组织NGAL因子的过分泌,并通过增加胰岛素抵抗(IR)参与了GDM的发生。NGAL能通过胎盘转运至胎儿并进一步影响胎儿的宫内生长发育。     

中性粒细胞白明胶酶转运蛋白与妊娠期糖尿病的研究进展

目前妊娠期糖尿病（GDM）的发病机制仍未阐明。近年研究认为,脂肪细胞因子、炎性分子介导的慢性炎症状态与GDM的发病相关。本文旨在对近年新发现的脂肪细胞因子成员一中性粒细胞白明胶酶转运蛋白（NGAL）参与慢性炎性、胰岛素抵抗及GDM的相关研究做一综述。     

中性粒细胞白明胶酶转运蛋白与子痫前期关系的探讨

目的:探讨子痫前期(PE)患者的血清中性粒细胞白明胶酶转运蛋白水平(NGAL)与PE严重程度的关系。方法:选取2011年9月至2013年4月在我院产科住院并分娩的单胎正常妊娠孕妇61例、轻度PE患者33例及重度PE患者24例。比较3组患者的孕前BMI、及新生儿出生体重,测定患者的24h尿蛋白和肌酐水平,应用酶联免疫吸附法(ELISA)测定血清NGAL水平,分析PE患者血清NGAL水平与24h尿蛋白和肌酐的相关性。结果:重度、轻度PE患者的血清NGAL水平显著高于正常妊娠孕妇[(83.8±14.9)ng/ml、(52.8±20.4)ng/ml vs(16.4±8.8)ng/ml,P0.001],重度PE患者显著高于轻度PE患者(P0.001)。PE患者的血清NGAL水平与24h尿蛋白(r=0.457,P0.001)、肌酐(r=0.497,P0.001)呈正相关性。结论:血清NGAL水平在PE患者中升高,且NGAL可能和疾病的严重程度有关。     

尿微量蛋白及尿酶测定对妊高征早期肾损伤的诊断价值

妊高征并发肾功能衰竭严重危害母儿生命安全。因此 ,早期发现肾脏有无损害极为重要。我们测定尿Ｎ -乙酰 - β -Ｄ -氨基葡萄糖苷酶 (ＮＡＧ)及微量蛋白 (ｍＡＬＢ)变化 ,以探讨其在诊断妊高征早期肾脏损伤中的作用 ,现报告如下。1　资料与方法1.1　研究对象　 1998年 9月至 1999年 9月间在我院产科分娩的初产妇 174例 ,年龄 2 2～ 31岁 ,平均 (2 6± 4)岁 ,孕周 2 8～ 42周 ,平均 (38 5± 4 9)周。既往无肾脏病史。按妊高征诊断及分类标准 (全国高等院校规划教材第四版 )分为正常晚孕组 6 2例 ,妊高征组 112例 ,其中轻、中度妊高征6 5例 ,…     

中性粒细胞明胶酶相关脂质运载蛋白在子宫内膜癌组织中的表达及临床意义

目的:通过研究子宫内膜癌(EC)组织中中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的表达情况,初步探讨NGAL在不同临床特征EC中的表达特点及其在EC发生发展中可能的作用。方法:选取1999年1月至2012年12月在北京大学第一医院就诊的子宫内膜癌患者标本77例和正常子宫内膜24例,同期培养子宫内膜癌Ishikawa、HEC-1-A及KLE细胞株,Western blot法检测NGAL蛋白的表达。结果:(1)NGAL在正常子宫内膜中几乎不表达,EC患者内膜中NGAL表达显著高于正常内膜(P=0.000);(2)正常子宫内膜、非典型伴癌变、高分化癌、中分化癌及低分化癌中NGAL表达有显著差异(P=0.002),其中高、中分化EC中NGAL表达水平均显著高于正常内膜(P=0.010,P=0.000);(3)EC患者中,血清CA125阳性者的NGAL表达水平显著低于阴性者(P=0.026);(4)NGAL的表达与年龄、病理分型、FIGO分期、淋巴结转移及脉管癌栓等均无关(P0.05)。结论:(1)NGAL在EC的发生发展中可能发挥二重性作用;(2)NGAL与肿瘤分化密切相关,高表达于高分化EC,可能为早期内膜癌变的标记物;(3)联合应用NGAL与血清CA125检测,可能在早期EC筛查和晚期EC的病情监测有一定的临床意义。     

子痫前期孕妇血清、胎盘组织MMP-9及NGAL表达变化及其意义的研究

目的:探讨孕妇血清基质金属蛋白酶-9(MMP-9)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平变化及胎盘组织中MMP-9mRNA、NGAL mRNA表达变化在子痫前期发病中的作用.方法:选取60例重度子痫前期孕妇,按发病时孕周不同分为早发型组(发病孕周≤34周)和晚发型组(发病孕周＞34周)各30例;另选30例正...     

中性粒细胞明胶酶相关脂质运载蛋白与子痫前期及妊娠期糖尿病孕妇糖代谢和脂代谢指标的相关性

目的 通过测定正常妊娠孕妇、子痫前期糖代谢正常患者、妊娠期糖尿病( gestational diabetes mellitus,GDM)患者及子痫前期合并GDM患者血清中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)水平,探讨NGAL与子痫前期、GDM孕妇糖代谢和脂代谢的相关性. 方法 选取2009年12月至2010年11月在广州医学院附属广东省妇女儿童医院定期产前检查并分娩的单胎正常妊娠孕妇、子痫前期糖代谢正常患者及GDM患者各77例,子痫前期合并GDM患者32例.测定所有研究对象血清NGAL、空腹血精、空腹胰岛素、脂代谢参数、尿酸、肌酐、乳酸脱氢酶及24 h尿蛋白等指标,测量血压,计算体重指数(body mass index,BMI),用稳态模型评估法计算胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMA-IR)评价胰岛索敏感性.正态分布资料用单因素方差分析及Student's t检验进行比较,非正态分布资料用Kruskal-Wallis H检验和Mann-Whitney U检验进行比较.采用Spearman相关分析和多元逐步回归法进一步分析. 结果 子痫前期合并GDM组孕妇血清NGAL水平高于子痫前期糖代谢正常组[(70.82±20.02) ng/ml与(56.17±18.22)ng/ml,t=3.65,P＜0.01]、GDM组[(43.99±14.82) ng/ml,t=5.97,P＜0.01]及正常妊娠组[(17.80±5.78) ng/ml,t=14.76,P＜0.01);子痫前期糖代谢正常组血清NGAL水平高于GDM组(t=5.90,P＜0.01);子痫前期合并GDM组和子痫前期糖代谢正常组中,子痫前期重度组血清NGAL水平均高于子痫前期轻度组[(76.44±28.06)ng/ml与(60.15±25.86) ng/ml,t=2.82,P＜0.05; (61.61±37.14) ng/ml与(46.30±13.97) ng/ml,t=4.74,P＜0.01].校正孕周、孕妇年龄后血清NGAL水平与孕前BMI(r=0.335,P＜0.01)、入组BMI(r=0.427,P＜0.01)、入组收缩压(r=0.648,P＜0.01),入组舒张压(r=0.664,P＜0.01)、空腹血糖(r=0.320,P＜0.01)、空腹胰岛素(r=0.381,P＜0.01)、HOMA-IR(r=0.399,P＜0.01)、甘油三酯(r=0.405,P＜0.01)、总胆固醇(r=0.145,P＜0.05)、游离脂肪酸(r=0.335,P＜0.01)、尿酸(r=0.292,P＜0.01)、肌酐(r=0.226,P＜0.01)及24 h尿蛋白(r=0.436,P＜0.001)呈正相关,与高密度脂蛋白胆固醇(r=-0.189,P=0.008)呈负相关.多元逐步回归分析显示,入组收缩压(β=0.251,P＜0.01),入组舒张压(β=0.351,P＜0.01)、HOMA-IR(β=0.265,P＜0.01)、24 h尿蛋白(β=0.140,P＜0.05)是血清NGAL的独立相关因素. 结论 子痫前期及GDM患者血清NGAL水平显著升高,与糖脂代谢及血管内皮功能失调相关,提示NGAL可能在子痫前期及GDM的病理生理过程中发挥作用.     

尿微量蛋白和尿酶在儿童过敏性紫癜早期肾损伤中的临床意义

目的探讨尿微量蛋白和尿酶在过敏性紫癜(HSP)患儿早期肾损伤中的作用和临床意义。 方法2004 10—2005 10在内蒙古医学院第三附属医院儿科和皮肤科住院的HSP患儿共43例，采用免疫散射比浊法和酶法测定患儿尿微量白蛋白(MA)、转铁蛋白(TRF)、β2 微球蛋白(β2 MG)和尿酶N 乙酰 β D 氨基 葡萄糖胺酶(NAG)的水平，同时检测尿常规和血尿素氮(BUN)、肌酐(Scr)水平。 结果HSP患儿尿4项指标明显高于对照组，4项指标异常率79.07%(34/43)，尿常规异常率13.95%(6/43)；37例尿常规正常者4项指标异常率达70.57%(28/37)，且4项指标较单项指标异常发生率高。 结论尿4项指标联合检测是诊断HSP早期肾损伤的灵敏指标，可作为临床早期诊断、早期干预治疗以降低肾损伤程度的可靠依据。     

儿童非紫绀型先天性心脏病体外循环术后急性肾损伤相关危险因素分析

目的探究儿童非紫绀型先天性心脏病体外循环术后急性肾损伤(AKI)相关危险因素。方法选取2013年8月至2016年8月在湖南省儿童医院心胸外科行体外循环手术治疗的非紫绀型先天性心脏病患儿450例作为研究对象,将患儿按术后是否出现AKI进行分组,AKI组80例,非AKI组370例。收集患儿的一般资料及临床资料,通过单因素分析以及Logistic回归分析探究其相关危险因素。结果两组患儿在性别、体质量、尿素氮、左室射血分数、血红蛋白方面比较差异无统计学意义(P0.05)。两组在年龄、血肌酐、肺炎或心力衰竭史、体外循环时间及主动脉阻断时间、术后低血压方面比较差异有统计学意义(P0.05)。通过Logistic对因素回归分析发现,年龄≤1岁、肺炎或心力衰竭史、体外循环时间以及主动脉阻断时间是危险因素。结论在非紫绀型先天性心脏病患儿行体外循环手术治疗中,选择手术年龄、缩短体外循环时间、缩短主动脉阻断时间以及预防并发症是有效的控制手段,可以降低患儿AKI的发病率。     

Angiotensin converting enzyme inhibitors induced acute kidney injury in newborn

Angiotensin converting enzyme inhibitors (ACEI) are known to cause fetopathies and acute kidney injury (AKI) in neonates. It is important to monitor neonates on ACEI to prevent severe rebound hypotension as well as an acute renal impairment or failure.     

Relationship of neutrophil gelatinase-associated lipocalin (NGAL) and procalcitonin levels with the presence and severity of the preeclampsia

Objective: The aim of the present study was to evaluate changes in maternal serum neutrophil gelatinase-associated lipocalin (NGAL) and procalcitonin (PCT) concentrations in preeclampsia.

Material and method: This case–control study consisted of 40 preeclamptic and 40 healthy singleton pregnancies matched for age and body mass index. Serum NGAL and PCT levels were compared between the groups. Diagnostic performance and clinical association of these markers were evaluated.

Results: NGAL and PCT concentrations were significantly higher in preeclamptic group (p?p?=?0.001, respectively) and their levels were correlated with the severity of the preeclampsia. There were significant positive correlation between these markers and mean arterial pressure (MAP) and spot urine protein excretion. There was negative correlation between NGAL and apgar scores and fetal birth weight. Pregnancies with higher NGAL (OR: 4.89; 95% CI: 1.81–13.21) and higher PCT (OR: 6.67; 95% CI: 2.44–18.21) concentrations had higher risk for preeclampsia.

Conclusion: NGAL and PCT may be potential biomarkers for preeclampsia. Their levels increase significantly in preeclampsia and they are related to the severity of the disease. These results are in agreement with the generalized endothelial damage and persistant inflammatory status in preeclampsia. NGAL may also be an indicator for adverse neonatal outcomes with decreased placental hypoperfusion.     

Analysis of urine biomarkers for early determination of acute kidney injury in non-septic and non-asphyxiated critically ill preterm neonates

Objective: We designed the present study to test the hypothesis that urinary biomarkers might predict acute kidney injury (AKI) development in non-septic and non-asphyxiated critically ill preterm infants. We evaluated urine (u) sistatin–C (uCys-C), kidney injury molecule–1 (uKIM–1) and neutrophil gelatinase associate lipocaline (uNGAL) as markers of AKI.

Methods: Sixty-four preterm infants with gestational age between 28 and 32 weeks were included in this study. Biomarkers were measured on day of life (DOL) 1, 3, and 7.

Results: uNGAL levels in the AKI group were significantly higher than in no-AKI group on DOL 1, 3 and 7 (p?=?0.016, p?=?0.007 and p?=?0.0014, respectively).

Conclusions: uNGAL is sensitive, early, and noninvasive AKI biomarkers, increasing significantly in non-septic and non-asphyxiated critically ill preterm neonates.     

Increase of neuronal injury markers Tau and neurofilament light proteins in umbilical blood after intrapartum asphyxia

Aim: Compare the levels of the brain injury biomarkers Tau and neurofilament light protein (NFL) in cases of asphyxia with those in controls.

Materials and methods: We analyzed the neuronal proteins Tau and NFL in umbilical blood of 10 cases of severe-moderate intrapartum asphyxia and in 18 control cases.

Results: The levels of both Tau and neurofilament were significantly higher after asphyxia and it appeared to be a correlation between the levels of the biomarkers and the severity of the insult.

Discussion: Future studies are warranted to support or refute the value of Tau/NFLin clinical practice.

Conclusion: Fetal asphyxia remains a clinical problem resulting in life-long neurological disabilities. We urgently need more accurate early predictive markers to direct the clinician when to provide neuroprotective therapy.     

Urinary neutrophil gelatinase-associated lipocalin is associated with preeclampsia in a cohort of Turkish women

Purpose: We investigated the optimal cut-off level for urinary neutrophil gelatinase-associated lipocalin (NGAL) in preeclamptic patients to confirm the diagnosis.

Methods: Urinary NGAL concentrations were measured by specific enzyme-linked immunosorbent assay (ELISA).

Results: Patients with preeclampsia had significantly higher urinary NGAL concentrations than controls (mean: 387 ng/ml vs. 188 ng/ml, respectively; P< 0.001). Using a cutoff value 252 ng/ml for urinary NGAL to confirm diagnosis of preeclampsia, sensitivity, and specificity were 92% and 91%, respectively.

Conclusion: Urinary NGAL concentrations were significantly elevated in women with preeclampsia versus normotensive controls.