| Neutrophil gelatinase-associated lipocalin (NGAL), also known as lipocalin-2.In the environment of inflammation and carcinoma. Kjeldsen is equivalent to 1993 in the study of the special granules of neutrophils in the matrix metalloproteinase 9 (metalloproteinases-9 matrix, MMP-9), the first to find the 25kDa size of the secreted glycoprotein. In the human body, the NGAL is present in two forms, at least in 25-kDa monomer,45-kDa, or of the two poly (or 135-kDa) of the, and 3 forms of the MMP-9 (with a combination of two sulfur bonds). NGAL in inflammation or chronic malignant tumor environment, human organs and tissues, such as uterus, salivary gland, kidney, breast, gastrointestinal epithelium can induce NGAL and normal kidney, lung, stomach, colon, etc. organization of NGAL expression level is low, but when these epithelial cells are damaged. NGAL is induced and abundantly expressed. In recent years, because of its NGAL in acute kidney injury in the early warning role of biology and attention, there is evidence that NGAL can be produced by renal tubular cells and renal injury greatly increased its concentration. In a series of clinical studies have conclusively proven that NGAL for acute kidney injury (AKI) has a value of diagnosis and assessment of prognosis. The NGAL is a diagnosis of acute kidney injury biochemical "gold standard", acute kidney injury occurs when blood and urine NGAL levels were increased, blood and urine NGAL detection can be as AKI diagnosis early, sensitive and very specific biological markers. Because of its value in the evaluation of acute renal damage is better than creatinine, urea, uric acid and creatinine clearance rate, which has become a hot spot in recent years.Objective:To investigate the indication of human urine and serum NGAL in the patients with acute renal injury caused by renal tumor operation. Through the research of NGAL in different renal artery blocking the expression level of patients with time, and postoperative review NGAL level analysis, NGAL and renal artery occlusion relationship between the cause of acute kidney injury and explore NGAL in renal injury severity and postoperative recovery degree evaluation.Methods:Clinical blood and urine samples were collected specifically into five groups: branch artery occlusion of the renal tumor enucleation surgery, kidney cancer radical resection, prostate cancer radical resection, resection of adrenal gland, renal pelvis and ureter stenosis at the plastic surgery. Surgical patients were collected before, during and after operation for five consecutive days of blood and urine, using ELISA to detect and observe the NGAL protein in serum and urine total concentration changes and trends, and with the follow-up, detection the serum NGAL level recovery.Results:1. Urinary NGAL levels were not significantly increased after surgery.2.The patients were divided into short time block and long block group by 35min renal artery occlusion, the two groups were significantly different.3. The levels of serum NGAL in the review of patients were returned to normal.Conclusions:1. Urinary NGAL levels indicating a weak role in the renal artery occlusion nephron sparing surgery induced acute renal failure..2. In blocking time 35 minutes divided into two groups, the difference between the two groups more significant, this result in the following clinical studies, there may be some clinical significance, clinical surgery has some indication.3. Radical resection of renal tumor patients serum NGAL levels rise significantly, it is worth further exploration in the following clinical studies.4. All patients after the review, levels of serum NGAL recovered to normal. Indicating the clinical safety and reliability of the branch artery occlusion of nephron sparing surgery of the renal tumors, and the patient has a better prognosis. |
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