研究指出在急性腎衰竭病患的尿液及血液檢體中，neutrophil gelatinase-associated lipocalin（NGAL）會快速急遽地增加。由於腎臟病患檢體中測得NGAL蛋白的時間遠早於肌酸酐、cystatin C及β2- microglobulin(β2-微球蛋白)等傳統評量腎臟損傷程度的分子，因此NGAL被視為是目前評量腎臟損傷程度最具潛力的早期生物指標。糖尿病腎病變是糖尿病患常見之小血管病變，盛行率約10%~42%，本研究收集21位糖尿病無腎病變者為對照組、21位糖尿病腎病變stage 2患者、26位糖尿病腎病變stage 3患者、9位糖尿病腎病變stage 4患者與16位糖尿病腎病變stage 5患者為研究組，進行NGAL及β2-microglobulin血漿濃度與腎病變之相關性研究。所有個案均接受血液收集與問卷調查，結果經統計發現研究組的尿素氮、肌酸酐、NGAL及β2-microglobulin含量均顯著高於對照組（P < 0.001），而腎絲球過濾率則顯著低於對照組（P < 0.001）。線性迴歸分析也發現NGAL與白血球、尿素氮、肌酸酐及β2-micrglobulin呈正相關性，與腎絲球過濾率呈負相關性；而β2-micrglobulin與尿素氮、肌酸酐及NGAL呈正相關性，與腎絲球過濾率呈負相關性。結果顯示糖尿病腎病變族群的血漿NGAL濃度與各腎功能參數呈正相關性，也與腎臟損傷呈高度相關，因此可推論NGAL在糖尿病腎病變的進程扮演重要的角色。

Diabetic nephropathy is a common diabetic microvascular disease with a prevalence of about 10% to 42%. Research has shown that neutrophil gelatinase-associated lipocalin (NGAL) levels would increase rapidly in the urine and blood of patients with acute kidney failure. NGAL may represent an early and predictive kidney injury biomarker due to the increase of NGAL occurs earlier than that of molecules (creatinine, cystatin C and β2-microglobulin) for traditional assessment of renal injury in renal disease samples. To evaluate the association of plasma level of NGAL and β2-microglobulin with diabetic nephropathy, this study was performed on 21 diabetic patients without nephropathy as the control group and 21 patients with diabetic nephropathy stage 2, 26 patients with stage 3, 9 patients with stage 4 and 16 patients stage 5 as the study group. Collection of blood and measurements of all cases were approved by the ethical committee. The results indicate that the levels of blood urea nitrogen (BUN), creatinine, NGAL, and β2-microglobulin of study group were significantly higher than control group (P<0.001), while the glomerular filtration rate (GFR) was significantly lower than the control group (P<0.001). Linear regression analysis show that NGAL was positively correlated with white blood cells, BUN, creatinine, β2-micrglobulin and negatively correlated with GFR; and β2-micrglobulin was positively correlated with BUN, creatinine, NGAL and negatively correlated with GFR. All results indicate that plasma NGAL levels in diabetic nephropathy were positively correlated with renal function parameters, and closely correlated with kidney injury, suggesting that NGAL may play an important role in the progression of diabetic nephropathy.

中文摘要 1
英文摘要 2
序論 4
實驗材料及方法 17
結果 24
討論 28
參考文獻 34
圖表 43

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