An Association Study On Damp-heat In Lower Jiao And Neutrophil Gelatinase-associated Lipocalin

TCM holds that diseases in lower jiao refer to the kidney and bladder. The disease in lower jiao mainly means the disease of urinary system diseases."The disease in lower jiao is caused by damp-heat", which is from Medical Formulae Investigations, points out that damp-heat in lower jiao is the significant pathogenesis. Chronic glomerulonephritis(CGN) and urinary tract infection(UTI), the common diseases of the urinary system, are closed to damp-heat. The damage on kidney caused by damp-heat is basal pathogenesis in CGN. And the basic pathological change on UTI is dampness-heat of bladder. A new lipocalin named NGAL participates in the development of the kidney disease and infection. NGAL can sensitively discover renal injury in AKI in the early. It also can evaluate renal function in CKD and predict the prognosis of disease. Besides, NGAL can participate in acute bacterial inflammation, and has bacteriostatic effect. Now, the research on NGAL in CGN and UTI is rare. To discuss the meaning of NGAL in CGN and UTI, and the relationship between damp-heat in lower jiao and NGAL, the changes of NGAL in CGN and UTI are observed.Objective:Observing the changes of NGAL and indexes(blood routine, urine routine, renal function,24h urine protein quantitative), analyzing the relationship between NGAL and indexes, which are to discuss the meaning of NGAL epressing on CGN and UTI. Observing the changes of NGAL in damp-heat syndrome of CGN and UTI, which is to discuss the relationship between NGAL level and damp-heat in lower jiao.Methods:Randomly selecting 30 cases of healthy physical examination, which is to measure NGAL concentration as a normal reference range. ELISA method is used to measure NGAL serum concentration, and dry-immunofluorescence is used to measure NGAL urine concentration. Collecting 58 cases of serum samples (31 cases of damp-heat syndrome group and 27 cases of non-damp heat syndrome group) and 36 cases of urine samples (21 cases of damp-heat syndrome group and 15 cases of non-damp heat syndrome group), which are from patients with CGN. Collecting 21 cases of urine samples, which are from patients with damp-heat UTI. Then NGAL concentration of these samples is measured. Besides, patients’ score of damp-heat symptoms and the indexes of blood routine and urine routine are recorded. The indexes of 24h urine protein quantitative and renal function in patients with CGN are recorded. Then, analyzing the relationship between NGAL and indexes, and the relationship between NGAL and score of damp-heat symptoms, which is needed.Results:1.Compared with healthy people, the concentrations of serum NGAL and urine NGAL in CGN group are higher, and the difference is statistically significant (P<0.05). Serum NGAL has a positive correlation with Scr, BUN,24h urine protein quantitative (0<r<1, P< 0.05). Serum NGAL is negatively correlated with GFR (r=0.521, P<0.01). The significant linear correlations between serum NGAL and neutrophils in the peripheral are not found (P>0.05). The significant linear correlation between urine NGAL and GFR is not found (P>0.05). Urine NGAL has a positive correlation with 24h urine protein quantitative (r=0.585, P<0.01). The significant linear correlations between urine NGAL and white blood cells or red blood cells in urine are not found (P>0.05).2.Compared with non-damp heat syndrome of CGN group, the concentration of serum NGAL and urine NGAL in damp-heat syndrome group are higher, and the difference was statistically significant (P<0.05). The significant linear correlation between score of damp-heat symptoms and the concentration of serum NGAL and urine NGAL is not found (P>0.05).3.Compared with healthy people, the concentration of urine NGAL in UTI group is higher, and the difference is statistically significant (P<0.01). Urine NGAL has a positive correlation with urine leucocyte (r=0.540, P<0.05). The significant linear correlation between urinary RBC and urine NGAL is not found (P>0.05). The concentration of urine NGAL in the group which urine protein is positive, is higher than the negative, and the difference is statistically significant (P<0.05).4.In damp-heat UTI group, urine NGAL has a positive correlation with score of damp-heat symptoms integral (r=0.729, P<0.01).5.Compared with CGN group, the concentration of urine NGAL in UTI group is higer, and the difference is statistically significant (P<0.01).6.Compared with the damp-heat UTI group, the concentration of urine NGAL in the damp-heat CGN group is lower, and the difference is statistically significant (P<0.05).Conclusion:1.The concentration of serum NGAL and urine NGAL can rise in patients with CGN. Serum NGAL in CGN patients is closely associated with renal function. When renal function decreases, serum NGAL concentration may rise. Serum NGAL level and urine NGAL level in CGN patients are closely associated with proteinuria level. Damp-heat in lower jiao can affect NGAL level.2. The concentration of urine NGAL can rise in patients with UTI. Urine NGAL level in UTI patients is associated with urinary white blood cells level and urine protein level. Damp-heat in lower jiao can affect NGAL level.3. There are differences on the increased degree of urine NGAL level between CGN and UTI. And he two dieases have differences on urine NGAL level in the damp-heat in lower jiao.