【摘要】 目的探讨腹膜透析相关性腹膜炎患者中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的表达与变化对疾病监测的意义。方法选择本中心收治的50例腹膜透析引出液细菌培养阳性的腹膜透析相关性腹膜炎患者,所选病例经头孢唑林1.0 g与头孢他啶1.0 g治疗2周后均痊愈。采集所有患者的临床资料、血和腹膜透析引出液标本,检测第1、3、7、14、21天外周血与腹膜透析引出液标本中WBC、NEU%、超敏C反应蛋白(hs-CRP)与IL-1β、TNF-α、NGAL的浓度。结果患者外周血NGAL水平在第1天为(1 725.6±341.2)ng/ml,而3 d后则迅速降至(1 130.4±234.6)pg/ml(P<0.05),2周后回落至(490.3±149.1)pg/ml(P<0.05),与3周后的NGAL水平[(452.7±137.2)pg/ml]之间无统计学差异,提示NGAL比其他指标的变化更为灵敏。结论根据腹膜透析相关性腹膜炎患者的血清NGAL水平可以较快速准确地评估腹膜炎的病情,可作为疗效监测的一个良好生物学指标。更多还原

【Abstract】 Objective To evaluate the expression of neutrophil gelatinase-associated lipocalin(NGAL) in patients with peritoneal dialysis-related peritonitis and the clinical significance of monitoring. Methods Fifty cases of peritoneal dialysis-related peritonitis patients with positive culture results of bacteria in dialysis effluent were selected. All of these patients were cured with 1.0 g cefazolin and 1.0 g ceftazidime. The clinical information, peritoneal dialysis effluent and blood specimens were collected to examine the concentration of high-sensitivity C-reactive protein(hs-CRP), IL-1 beta, TNF-alpha and NGAL at day 1, 3, 7, 14 and 21. Results The NGAL level of serum was(1 725.6±341.2)ng/ml at day 1 and declined to(1 130.4±234.6)pg/ml rapidly after treating for 3 days(P<0.05). The NGAL level of serum fell back to(490.3±149.1)pg/ml(P<0.05) at day 14 and recovered to baseline level [(452.7±137.2) pg/ml] at day 21. The level had no difference between day 14 and day 21. The serum NGAL changed more sensitive than the other markers. Conclusion The NGAL level of serum in peritoneal dialysis-related peritonitis patients could reflect the severity of peritonitis quickly and accurately. It might be used as a good biological indicator to monitor therapeutic effect.更多还原