目的 探讨尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）在IgA肾病（IgAN）患者肾小管间质损伤（TIL）评估中的意义。方法 应用酶联免疫法( ELISA)检测110例IgAN患者，30例非IgAN肾小球疾病患者以及30例健康对照者的尿NGAL水平。结果 IgAN组、非IgAN疾病对照组较健康对照组尿NGAL水平均明显升高（P<0.01）；IgAN组尿NGAL水平与多项临床病理指标明显相关；影响尿NGAL水平的独立影响因素有血白蛋白水平，尿蛋白定量、尿NAG酶、尿渗透压，以及球性硬化、间质炎细胞浸润、间质纤维化、肾小管萎缩；以尿NGAL水平超过正常对照组2个标准差视为显著增高,联合NAG酶对有无TIL进行评估，ROC曲线下面积为0.850，明显优于血肌酐的0.675，灵敏度83.3％，特异度73.3％，准确率81.2％。结论 IgAN患者尿NGAL水平可以反映IgAN病情程度，在联合尿NGAL与尿NAG酶判别有无TIL时明显优于血肌酐及单纯的尿NGAL、尿NAG酶、尿渗透压等指标。

Objective To investigate the significance of urinary NGAL in assessing tubulointerstitial lesions in IgA nephropathy. Methods Urine NGAL level was detected by ELISA in 115 cases with IgAN, 30 cases with non-IgAN glomerulonephritis, and 30 healthy controls. Results The levels of urine NGAL in IgAN or non-IgAN glomerulonephritis patients were higher than that in healthy controls (P<0.01). The levels of urine NGAL in IgAN were significantly correlated with many clinical and pathology parameters. The independent influencing factors on urine NGAL included blood albumin, urine protein, NAG enzyme, urine osmotic pressure, and tubulointerstitial lesions. To evaluate whether or not TIL existed, ROC analysis of urine NGAL combining NAG enzyme showed that AUC was 0.850, and the sensitivity and specificity were 83.3% and 73.3% respectively, while the AUC for serum creatinine was 0.675. Conclusion The levels of urine NGAL in IgAN could reflect the degree of illness. The combined detections of urine NGAL and NAG enzyme are better in evaluating whether or not TIL existed than the single detection of serum creatinine, urine NGAL, urine NAG, or osmotic pressure alone.