NGAL-涓€х矑缁嗚優鏄庤兌閰剁浉鍏宠剛璐ㄨ繍杞借泲鐧芥祴瀹氳瘯鍓傜洅(鑳朵钩鍏嶇柅姣旀祳娉?
--鎬ユ€ц偩鎹熶激(AKI)鐨勬棭鏈熸晱鎰熸寚鏍嘃/h3>
鏍锋湰绫诲瀷锛氳娓呫€佽娴?鑲濈礌鎶楀嚌)鎴栧翱娑层€侟/p>
閫傜敤浠櫒锛氭湰璇曞墏鐩掗€傜敤浜庣粷澶у鏁颁富娴佺敓鍖栧垎鏋愪华
璇曞墏鐩掍紭鍔军/h4>
1.琛€灏垮悓妫€
2.閲囩敤鑳朵钩鍏嶇柅姣旀祳娉曪紝鎻愰珮鐏垫晱搴﹀拰鐗瑰紓鎬?/p>
3.绾挎€ц寖鍥村锛?0锝?000 ng/mL
鎸囨爣绠€浠婞/h3>
涓€х矑缁嗚優鏄庤兌閰剁浉鍏宠剛璐ㄨ繍杞借泲鐧斤紙Neutrophil Gelatinase-Associated Lipocalin锛孨GAL锛夛紝鏄叡浠风粨鍚堝湪涓€х矑缁嗚優鏄庤兌閰剁殑铔嬬櫧璐紝鍒嗗瓙閲?5kDa锛屾湁鍗曚綋銆佸悓婧愪簩鑱氫綋銆佸紓婧愪簩鑱氫綋绛夊舰寮忥紝鍦ㄤ腑鎬х矑缁嗚優銆佽偩銆佺粨鑲犮€佽偤涓婄毊缁嗚優绛変綆涓板害琛ㄨ揪锛屼絾鍦ㄥ彈鎹熺殑涓婄毊缁嗚優涓〃杈炬樉钁椾笂鍗囥€侼GAL鏄竴绉嶈剛璐ㄨ繍杞借泲鐧斤紝鍏锋湁杩愯緭鐤忔按鎬у皬鍒嗗瓙鐨勫姛鑳斤紝鍙互涓庡熀璐ㄩ噾灞炶泲鐧介叾9锛圡MP-9锛夌粨鍚堬紝璋冭妭MMP-9鐨勫姛鑳斤紱鍙備笌鐐庣棁浠嬭川鐨勬竻闄ゅ強鍏嶇柅璋冭妭锛涘弬涓庡惈閾佺墿璐ㄧ殑杞繍锛屼績杩涜偩鑴忔崯浼ゅ悗缁嗚優澧炴畺锛屽叿鏈夎偩淇濇姢浣滅敤锛涘弬涓庨搧浠ｈ阿锛屽湪缁嗚優鍐呯粨鍚堥搧鍏冪礌锛屽彂鎸ユ姉鑿屻€佷績杩涘噵浜″強鎶戝埗澧炴畺浣滅敤锛涘叏韬绯荤粺鐤剧梾濡傛€ユ€ц偩鎹熶激銆佹參鎬ц偩鑴忕柧鐥呫€佹伓鎬ц偪鐦わ紙濡傜粨鐩磋偁鐧岋級绛夛紱鎬ユ€ц偩鎹熶激锛圓KI锛夊彂鐢?灏忔椂鍗冲紑濮嬩笂鍗囷紝鏄疉KI鏃╂湡璇婃柇鐨勭壒寮傛爣蹇楃墿銆侟/p>
妫€娴嬪師鐞咟/h3>
鏍锋湰涓殑NGAL涓庤瘯鍓備腑鎶椾汉NGAL鎶椾綋鑳朵钩棰楃矑鍙戠敓鍑濋泦鍙嶅簲锛屽嚌闆嗗弽搴斿舰鎴愮殑鎶楀師鎶椾綋鍏嶇柅澶嶅悎鐗╄€屼骇鐢熸祳搴︼紝鍦ㄦ姉浣撻噺涓€瀹氭椂锛屽叾娴婂害楂樹綆涓庢牱鏈腑鐨凬GAL鍛堟鐩稿叧銆傞€氳繃娴嬪畾鐗瑰畾娉㈤暱鐨勫惛鍏夊害鍊硷紝鍙傜収鏍″噯鏇茬嚎鍗冲彲璁＄畻鍑篘GAL鐨勫惈閲忋€侟/p>
涓村簥搴旂敤
- NGAL鏄€ユ€ц偩鎹熶激(AKI)鏃╂湡璇婃柇銆佸嵄闄╁垎灞傚強棰勫悗鍒ゆ柇鎸囨爣銆侼GAL浣滀负鏃╂湡璇婃柇AKI鐨勬柊鍨嬫寚鏍囨晱鎰熶笖鐗瑰紓锛屽苟鏄庢樉楂樹簬鍏朵粬浼犵粺鑲炬崯浼ゆ爣蹇楃墿濡傝鑲岄厫(Scr)銆佸翱N-涔欓叞钁¤悇绯栬嫹閰?NAG)绛夛紝鏄瘖鏂瑼KI鏃犲垱銆佽繀閫熴€佺伒鏁忕殑鐢熺墿瀛︽爣蹇楃墿銆侫KI鏃讹紝琛€銆佸翱NGAL娴撳害閫氬父浼氳繀閫熷崌楂橈紝2灏忔椂鏈€涓烘槑鏄?姣斾复鐣屽€煎崌楂樺嚑鍗佽嚦鍑犵櫨鍊?锛岃€岃鑲岄厫(SCr)銆佸翱绱犳爱绛変紶缁熸寚鏍囧線寰€瑕佸湪24~72h鍚庢墠鏄庢樉鍗囬珮銆傚洜鑰孨GAL鍙敤浜嶢KI鐨勬棭鏈熻瘖鏂€侟/li>
- NGAL鏄疉KI鍗遍櫓鎬у垎灞傚拰棰勫悗鍒ゆ柇鐨勬晱鎰熸寚鏍囥€傜爺绌跺彂鐜帮紝褰撳彂鐢熸€ユ€ц偩鎹熶激鏃讹紝琛€娓匩GAL姘村钩鏄庢樉鍗囬珮;褰撴湁鏁堟不鐤楀悗锛岃娓匩GAL姘村钩鏄庢樉涓嬮檷;鎮ｈ€呯梾鎯呰秺涓ラ噸锛屽叾琛€娓匩GAL姘村钩瓒婇珮锛岄鍚庢晥鏋滆秺涓嶇悊鎯炽€傛湁鐮旂┒鍙戠幇锛孉KI鍒嗘湡涓庤銆佸翱NGAL姘村钩鍛堟鐩稿叧锛屾彁绀篘GAL涓庤偩鎹熷鐨勪弗閲嶇▼搴︾浉涓€鑷滁span style="color:hsl(212,80%,42%);">[1]銆侼GAL鍙娴婣KI闄㈠唴姝讳骸鐜嘃span style="color:hsl(212,80%,42%);">[2]銆侟/li>
- 灏縉GAL鍙緟鍔╅壌鍒偩鍓嶆€KI涓庤偩鎬KI銆係eibert绛堻span style="color:hsl(212,80%,42%);">[3]鐮旂┒鍙戠幇锛岃偩鎬KI鎮ｈ€呭翱NGAL鏄庢樉楂樹簬鑲惧墠鎬KI 鑰咃紝ROC鏇茬嚎涓嬮潰绉负0.82锛屽彇 52 ng/mL浣滀负璇婃柇涓寸晫鍊硷紝鍏舵晱鎰熷害鍜岀壒寮傚害鍒嗗埆涓?5.3%鍜?2.4%銆侟/li>
- 琛€NGAL鍙綔涓哄垽AKI鎮ｈ€呭紑濮嬭偩鑴忔浛浠ｆ不鐤?renal replacement treatment,RRT)鐨勬棭鏈熼娴嬫寚鏍囥€俆iranathanagul 绛堻span style="color:hsl(212,80%,42%);">[4]瀵?7渚嬫湭杈惧埌浼犵粺閫忔瀽鎸囧緛鐨凙KI 2-3 鏈熸偅鑰呯殑琛€銆佸翱NGAL琛孯OC鏇茬嚎鍒嗘瀽锛屽彂鐜拌NGAL棰勬祴RRT娌荤枟鐨凴OC鏇茬嚎涓嬮潰绉负0.813锛屽叾鏈€浣抽娴嬬晫鍊?60ng/mL涓哄紑濮婻RT娌荤枟鐨勬椂鏈猴紝鍏舵晱鎰熸€?2.2%锛岀壒寮傛€?9.6%銆侟/li>
- 灏縉GAL鍙綔涓篈KI鎭㈠绋嬪害鐨勭嫭绔嬮娴嬪洜绱燑span style="color:hsl(212,80%,42%);">[5]銆傞殢鐫€琛€NGAL娴撳害涓嬮檷锛孉KI涔熷緱鍒颁竴瀹氭仮澶嶃€傝繖瀵规偅鑰呴鍚庣殑璇勪及锛屾不鐤楁柟妗堢殑鍒跺畾锛屽噺灏戞參鎬у寲杩涘睍鐨勫彲鑳芥湁閲嶈鎰忎箟銆侟/li>
- NGAL鍙緝琛€鑲岄厫鏇存棭鍦伴娴嬭偩绉绘鏈悗鑲惧姛鑳界殑鎭㈠銆侺iu绛堻span style="color:hsl(212,80%,42%);">[7]鐮旂┒鍙戠幇锛?9渚嬫帴鍙楁椿浣撹偩绉绘鐨勫彈鑰呮湳鍚庤NGAL鍊奸檷鍒版甯哥殑鏃堕棿姣旇鑲岄厫鏇村揩锛屽湪澶氬彉閲忓垎鏋愪腑锛屾湳鍚庡綋澶㎞GAL鍊兼槸绉绘鑲惧姛鑳芥仮澶嶆椂闂寸殑鐙珛棰勬祴鍥犲瓙銆侟/li>
- NGAL涓庢參鎬ц偩鑴忕梾锛氶殢鐫€瀵筃GAL鐨勭爺绌舵繁浜猴紝鍙戠幇 NGAL涓嶄粎鍙綔涓篈KI鐨勬棭鏈熺敓鐗╁鏍囪鐗╋紝鍦ㄦ參鎬ц偩鑴忕梾(CKD)璇婃柇涓悓鏍峰彂鎸ラ噸瑕佷綔鐢紝澶ч噺鐮旂┒璇佸疄浜哊GAL涓嶤KD杩涘睍鐨勭浉鍏虫€с€侭olignano绛堻span style="color:hsl(212,80%,42%);">[8]鐩稿叧鐮旂┒鍙戠幇NGAL闅忕潃eCFR姘村钩鐨勯檷浣庤€屽崌楂橈紝NGAL鍙綔涓洪娴嬫畫鐣欒偩灏忕悆婊よ繃鍔熻兘鐨勭嫭绔嬪洜瀛愶紝涓斿湪棰勬祴CKD杩涘睍鏂归潰锛屽翱NGAL鐨勭簿纭害浼樹簬琛€NGAL锛岃€岀伒鏁忓害绋嶄綆浜庤NGAL銆侟/li>
- 灏縉GAL鏄娴嬬嫾鐤€ц偩鐐?LN)鐨勬晱鎰熺壒寮傛寚鏍囷紝鐩戞祴灏縉GAL鍙娴婰N娲诲姩鍜岃繘灞曘€侭runner绛堻span style="color:hsl(212,80%,42%);">[9]鐮旂┒鍙戠幇锛岀粡鑲炬椿妫€纭瘖LN鐨勬偅鑰呭翱NGAL姘村钩楂樹簬鑲炬椿妫€鏃燣N鐨勬偅鑰咃紝涓擭GAL涓嶭N鐨勪弗閲嶇▼搴﹀強鐐庢€ф椿鍔ㄥ害瀵嗗垏鐩稿叧銆傜洃娴嬪翱NGAL姘村钩鍙弽鏄犺偩鑴忓眬閮ㄦ崯浼わ紝棰勬祴LN娲诲姩鍜岃繘灞曘€侾itashny绛堻span style="color:hsl(212,80%,42%);">[10]鍦ㄦ湁鍏砃GAL涓嶭N娲诲姩搴﹀叧绯荤殑鐮旂┒涓彂鐜帮紝LN鎮ｈ€呯殑灏縉GAL鏄捐憲鍗囬珮锛屼笖涓庤偩鑴廠LE鐤剧梾娲诲姩鎸囨暟璇勫垎瀵嗗垏鐩稿叧锛屼絾涓庤偩澶朣LEDAI璇勫垎鏃犳槑鏄剧浉鍏虫€с€傛澶栵紝Hammad绛堻span style="color:hsl(212,80%,42%);">[11]瀵规湁鏃犲苟鍙慙N鐨勬椿鍔ㄦ€LE鎮ｅ効鐮旂┒锛屽彂鐜板翱NGAL涓嶴LE娲诲姩搴﹀憟姝ｇ浉鍏炽€傛垜鍥界殑涓€椤圭爺绌跺娲诲姩鏈熷拰闈欐鏈烲N鐨勫翱NGAL姘村钩浣淩OC鏇茬嚎锛屽彂鐜板綋灏縉GAL姘村钩>0.585 ng/mg鏃讹紝闇€鐫€閲嶈€冭檻娲诲姩鏈烲N鐨勫彲鑳姐€傛湁鐮旂┒鍙戠幇锛屽翱NGAL瀵筁N娲诲姩鎬х殑棰勬祴浣滅敤浼樹簬鎶梔s-DNA鎶椾綋[12]銆侟/li>
- NGAL鏄棭鏈熺硸灏跨梾鑲剧梾(DN)鐨勬晱鎰熸寚鏍囥€傚浗鍐呭鐮旂┒琛ㄦ槑锛岃娓呬腑鎬х矑缁嗚優鏄庤兌閰剁浉鍏宠浇鑴傝泲鐧?sNGAL)涓嶥N鐨勫彂鐢熷彂灞曞瘑鍒囩浉鍏筹紝鍦ㄥ井閲忕櫧铔嬬櫧灏垮嚭鐜颁箣鍓嶅彲妫€娴嬪埌sNGAL姘村钩鐨勫鍔狅紝姣斿井閲忕櫧铔嬬櫧灏挎洿鏁忔劅鍜岀壒寮傘€傚洜姝わ紝sNGAL鏈夋湜鎴愪负璇婃柇鏃╂湡DN鏂扮殑鐢熺墿瀛︽爣蹇楃墿[13]銆侟/li>
- 灏縉GAL鏄珮琛€鍘嬭偩鐥呮棭鏈熷嚭鐜扮殑鏍囧織鐗┿€傞珮琛€鍘嬫偅鑰呰偩灏忕鍔熻兘鎹熷澶氬厛浜庤偩灏忕悆鍔熻兘鎹熷锛屽洜姝ゅ翱NGAL鍙樺寲鍙湁鏁堝弽鏄犺偩灏忕鎹熶激绋嬪害锛岃繘鑰岃瘎浠烽珮琛€鍘嬫棭鏈熻偩鍔熻兘鎹熷銆傝档鐜夊啗[14]鐮旂┒鍙戠幇锛岄珮琛€鍘嬫偅鑰呭翱NGAL姘村钩鍦ㄧ梾鐞嗘€ц泲鐧藉翱鍑虹幇鍓嶅氨宸茬粡缁х画鍗囬珮锛屽苟闅忚偩鍔熻兘鎹熷绋嬪害鍔犻噸鑰岀户缁崌楂橈紝灏縉GAL鏄珮琛€鍘嬭偩鐥呮棭鏈熷嚭鐜扮殑鏍囧織鐗?灏縉GAL姘村钩杈僑cr銆乪GFR鏇寸伒鏁忓湴鍙嶆槧楂樿鍘嬫偅鑰呯殑铔嬬櫧灏挎按骞冲強鑲惧姛鑳芥崯瀹崇▼搴︼紝妫€娴嬮珮琛€鍘嬫偅鑰呭翱NGAL姘村钩瀵硅偩鍔熻兘鎹熷鐨勬棭鏈熻瘖鏂洿鏈夋剰涔夈€侟/li>
- NGAL鍙兘鏄績琛€绠℃浜′簨浠剁殑鐙珛棰勬祴鍥犲瓙銆傚椤圭爺绌惰〃鏄庯紝NGAL鐨勮〃杈炬按骞充笌蹇冭剳琛€绠＄柧鐥呯殑涓ラ噸鎬у瘑鍒囩浉鍏筹紝鏈哄埗涓昏鏄洜涓哄姩鑴夌播鏍风‖鍖栨槸鍐犲績鐥呯殑鐥呯悊鐢熺悊鍩虹锛孨GAL浣滀负涓€绉嶇値鎬у弽搴旀爣蹇楃墿鍦ㄤ笉绋冲畾绮ユ牱纭寲鏂戝潡涓珮琛ㄨ揪锛屽悓鏃跺彲浠ュ弽鏄犲啝蹇冪梾鍙戠敓鍙戝睍鐨勭梾鐞嗚繃绋嬨€ NGAL鍙兘鏄績琛€绠℃浜′簨浠剁殑鐙珛棰勬祴鍥犲瓙[15]銆備竴椤瑰ぇ鏍锋湰銆佸涓績銆佸墠鐬绘€х爺绌舵寚鍑猴紝NGAL鑳界嫭绔嬮娴嬫參鎬у績鍔涜“绔?CHF)鐨勯鍚庡強鍗遍櫓绛夌骇[16]锛岃繖涓粨璁簐an Deursen鍦?014骞翠篃鏈夎瘉瀹烇紝鑰屼笖杩樺彂鐜板嵆浣挎偅鑰呮湭鍙戠敓鑲惧姛鑳戒笉鍏紝楂楴GAL姘村钩鐨凜HF鎮ｈ€呮浜＄巼鏄庢樉涓婂崌銆侟/li>
閫傜敤绉戝
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閫傜敤绉戝 |
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鑲惧唴绉慄/strong> |
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蹇冨唴绉慄/strong> |
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