良性前列腺增生患者尿NAG活性检测的临床意义

目的 探讨尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)活性检测在良性前列腺增生(BPH)患者肾功能损害判断中的意义.方法 采用速率法检测65例BPH患者尿NAG活性、放射比浊法检测血β2-MG、紫外法检测BUN、苦味酸法检测Cr及尿动力学检测最大尿流率,并与80例年龄匹配的健康人群检测结果进行比较分析.结果 BPH患者尿NAG活性水平(29.55±12.81)U/g Cr,明显高于健康对照组(16.91±6.87)U/g Cr(t=3.052,P＜0.01).直线回归分析显示:BPH患者尿NAG活性水平与最大尿流率之间呈显著相关(r=0.795,P＜0.01).患者中合并双肾积水9例,尿NAG含量(94.50±44.16)U/g Cr,与不伴肾积水组(19.12±1.73)U/g Cr比较差异有统计学意义(t=5.087,P＜0.01).结论 BPH患者最大尿流率较低时肾功能可能已有部分受损,尿NAG活性可能作为判断BPH患者早期肾功能损害的监测指标及手术指征之一.     

肾结石患者尿NAG和尿微量白蛋白动态检测及其意义

目的：探讨肾结石患者手术前后尿酶变化及意义.方法：对167例肾结石患者在行微创经皮肾镜取石术（mPCNL）前1周、63例在mPCNL后1周、33例在mPCNL后1个月分别检测尿N-乙酰-β-D氨基葡萄糖苷酶（NAG）/Cr、mAlB/Cr.结果：与无肾结石对照组相比,mPCNL术前和术后1周的NAG/Cr和mAlB/Cr有统计学意义（P＜0.01）;mPCNL术后1周和术后1个月的NAG/Cr与术前无统计学意义,而mAlB/Cr有统计学意义（P＜0.01）.mPCNL术后1个月与术后1周相比：NAG/Cr有统计学意义（P＜0.05）,而mAlB/Cr无统计学意义.结论：尿NAG、尿微量白蛋白可动态监测肾结石患者早期肾损害.     

检测尿NAG活性对判断BPH患者早期肾功能损害的意义

目的 探讨测定尿N-乙酰-β-D氨基葡萄糖苷酶（NAG）活性在判断良性前列腺增生症（BPH）患者早期肾功能损害方面的应用价值。方法 检测65例BPH患者的尿NAG活性及血β2微球蛋白（β2-MG）、尿素氮（BUN）、肌肝（Cr）及最大尿流率（Qmax），并与80例年龄匹配的正常人群进行比较分析。同时对BPH患者手术前与术后1个月和3个月的NAG活性进行比较。结果BPH患者尿NAG活性明显高于正常对照组（P〈O．01），尿NAG活性与BPH患者最大尿流率呈显著正相关（P〈O．01）。术后3个月尿NAG活性下降明显，与术前相比有显著性差异（P〈O．01）。结论BPH患者最大尿流率较低时肾功能可能已有部分损伤，尿NAG活性水平可作为判断BPH患者早期肾功能损伤的监测指标以及手术指征之一。     

肝移植术后他克莫司血药浓度与尿α1微球蛋白及微量白蛋白的相关性研究

目的选择能够早期反映同种异体原位肝移植术后他克莫司（FK506）对患者肾功能损伤的灵敏指标。方法回顾性分析我院自2000年2月至2005年5月的15例肾功能正常的肝移植患者的临床资料，重点分析其尿α1微球蛋白（α1-MG）和微量白蛋白（mAlb）以及血肌肝（Cr）和尿素氮（BUN）与FK506血药浓度之间的关系。结果15例肝脏移植患者，尿α1-MG及mAlb含量与FK506血药浓度呈正相关（r=0．939，P〈0．005；r=0．893，P〈0．05），血Cr及BUN与FK506血药浓度无相关性（r=0．490，P〉0．05；r=0．382，P〉0．05）。结论尿α1-MG和mAlb可作为反映肾功能损伤的早期的灵敏指标，有利于监测肝移植术后FK506的理想全血浓度，能够为临床早期诊断和治疗肾功能损伤提供参考指标。     

尿NAG测定在原发性肾病综合征中的应用

组织化学方法证实肾脏近端肾小管上皮细胞中尿N-乙酰-β-D-氨基葡萄糖苷酶(简称NAG)含量特别丰富.因其分子量大,在正常情况下,血清中NAG不能通过肾小球滤过膜.当肾小管损伤时,尿中NAG升高.原发性肾病综合征(NS)可并发肾小管的损害,而肾小管的损害被认为是决定肾功能恶化的重要因素[1],故尿NAG是观察NS患者肾小管损伤较为敏感的指标.我们对108例NS患者的尿NAG进行测定,观察报告如下.     

尿NGAL在2型糖尿病肾病肾小管间质损伤评价中的价值

目的探讨尿中性粒细胞明胶酶相关载脂蛋白(NGAL)对评价2型糖尿病肾病(DN)患者肾小管间质损伤的价值。 方法研究对象为2012年1月至2015年12月第三军医大学大坪医院2型糖尿病患者167例(2型糖尿病组);将2型糖尿病组再分为正常白蛋白尿组(n＝56)、微量白蛋白尿组(n＝58)、大量白蛋白尿组(n＝53),其中51例患者进行了肾活检。50例非糖尿病患者作为正常对照组。采用酶联免疫吸附测定方法检测尿液中NGAL水平,分光光度法测定尿N-乙酰-β-D-葡萄糖苷酶(NAG)。分析尿NGAL水平与肾功能相关指标[尿NAG、尿白蛋白/肌酐比值(ACR)、eGFR]及肾组织损伤病理评分之间的相关性,以及NGAL对DN肾小管间质损伤严重程度的评价效能,采用SPSS软件进行统计学分析,相关性分析采用Pearson或Spearman方法。 结果糖尿病患者尿NGAL水平较非糖尿病正常对照组明显增加;尿NGAL水平与尿NAG、ACR呈正相关(r＝0.528, 0.578,P<0.001),与eGFR呈负相关(r＝－0.637,P<0.001);尿NGAL水平与DN肾小管萎缩与间质纤维化(IFTA)的严重程度呈显著正相关(r＝0.652,P<0.001);尿NGAL曲线下面积最大(AUC＝0.868),特异度94.7%,敏感度71.9%。 结论尿NGAL是评价DN肾小管间质损伤理想的生物标志物之一。     

血清C反应蛋白与白蛋白比值、尿基质金属蛋白-7及微量白蛋白与上尿路结石术后感染的关系

目的探讨血清C反应蛋白(CRP)与白蛋白(Alb)比值(CRP/Alb)、尿基质金属蛋白-7(MMP-7)及微量白蛋白(mAlb)与上尿路结石输尿管软镜碎石术(FUL)后感染的关系及预测价值。方法选取2021年10月至2022年10月郑州大学第一附属医院FUL术后发生尿路感染的上尿路结石患者54例, 作为研究组, 另选同期、同年龄段FUL术后未发生尿路感染的上尿路结石患者54例, 作为对照组。比较两组一般资料、手术前后血清常规炎性因子[降钙素原(PCT)、白细胞介素-6(IL-6)]、CRP/Alb水平及尿MMP-7、mAlb水平, 分析研究组血清CRP/Alb、尿MMP-7、mAlb与常规炎性因子的相关性, 并比较不同感染程度患者手术前后血清CRP/Alb水平及尿MMP-7、mAlb水平, 分析血清CRP/Alb水平及尿MMP-7、mAlb水平与感染程度的相关性, 及预测FUL术后尿路感染的价值, 并与血清常规炎性因子预测价值进行比较, 采用Spearman/Pearson相关系数分析研究组术后血清CRP/Alb、尿MMP-7、mAlb与常规炎性因子、感染程度的相关性。结果研究组术后...     

心瓣膜置换术患者围术期尿NAG/Cr变化及乌司他丁对肾的保护作用

目的　了解心瓣膜置换术患者围术期尿 N-乙酰 - β- D-氨基葡萄糖苷酶 (NAG) /肌酐 (Cr)的变化 ,观察乌司他丁对肾的保护作用。　方法　 5 3例心瓣膜置换术患者用抽签法随机分为两组。实验组 :2 3例 ,给乌司他丁 2 0 0 0 0U/ kg,分 3次静脉注射 ;对照组 :30例 ,静脉注射生理盐水 2 0 m l。分别于术前 30 min,主动脉阻断前 5 min,主动脉开放后 5 min,手术结束 ,术后第 1、3、5 d检测尿 NAG/ Cr值、血尿素氮 (BU N)和血 Cr等指标。　结果　两组患者的尿NAG/ Cr值均于手术开始后升高 ,于主动脉开放后 5 min和手术结束时达到高峰 ;主动脉开放后 5 min、手术结束时和术后第 1d,实验组患者尿 NAG/ Cr值明显低于对照组 (P<0 .0 5 )。尿 NAG/ Cr值与体外循环 (CPB)时间、主动脉阻断时间和 TM- 5 0 (平均灌注压低于 5 0 mm Hg的时间压力积分 )呈正相关 (r=0 .5 6 0 ,0 .4 93,0 .5 0 5 ;P<0 .0 5 )。　结论　CPB时间、主动脉阻断时间和 TM- 5 0可影响尿 NAG/ Cr,乌司他丁对心瓣膜置换术患者围术期的肾损伤有一定的保护作用。     

黄葵胶囊对慢性肾炎患者尿蛋白肌酐比值、尿NAG酶的临床观察

目的:探讨黄葵胶囊对慢性肾炎患者尿蛋白肌酐比值(UP/Ucr)、尿NAG酶的影响。方法:随机将80例慢性肾炎患者分为治疗组和对照组,每组40例,两组在常规治疗的基础上,治疗组给予黄葵胶囊,对照组给予贝那普利片,治疗观察8周,比较用药前后患者的症状、UP/Ucr、尿NAG及肾功能的变化。结果:用药前后比较,治疗组总有效率85.0%,对照组总有效率82.5%,两组比较,治疗组高于对照组,但差异无统计学意义,两组均降低了UP/Ucr、尿NAG酶,改善了患者的肾功能,两组比较差异无统计学意义。结论:黄葵胶囊对慢性肾炎蛋白尿具有一定的治疗作用。     

~(99)Tc~m-DTPA肾动态显像与β_2-MG及mAlb联合检测对糖尿病患者早期肾功能损害诊断价值的探讨

目的：探讨99Tcm-DTPA肾动态显像与β2-微球蛋白（β2-MG）、尿微量白蛋白（mAlb）联合检测对糖尿病患者早期肾功能损害诊断价值及临床意义。方法：选取糖尿病患者60例,正常对照20例。肾动态显像分别测定肾小球滤过率（GFR）和肾有效血浆流量（ERPF）及放射免疫分析法测定血、尿β2-MG与尿mAlb。结果：与对照组相比,病程〈5年的糖尿病患者血、尿β2-MG与尿mAlb增加;且GFR、ERPF也上升;与病程5年～10年和〉10年者比较,而GFR、ERPF下降,有统计学意义（P〈0.05）。结论：99Tcm-DTPA肾动态显像测定GFR、ERPF与β2-MG、mAlb联合检测对判断糖尿病患者早期肾功能损害程度的诊断及临床分期、治疗、预后评估具有重要的应用价值。     

Studies of urinary proteins, FDP (fibrinogen degradation products), and NAG (N-acetyl-beta-D-glucosaminidase) in renal transplanted patients

The urinary proteins, FDP (fibrinogen degradation products), and NAG (N-acetyl-beta-D-glucosaminidase) in renal transplanted patients were studied. SDS (sodium dodecyl sulphate) electrophoresis was used for the differentiation of urinary proteins according to their molecular size. In the azathioprine-treated patients with stable renal function, most of the urinary proteins were albumin. However, the low molecular weight (LMW) proteins, which were suggestive of tubular proteins, appeared in the urine of the ciclosporin-treated patients with stable renal function. During the rejection episodes of the ciclosporin-treated patients, the fraction of LMW proteins increased. The elevation of urinary FDP and NAG index (urinary NAG/urinary Cr) were detected in association with rejection episodes. Urinary NAG index increased in proportion to the elevation of serum Cr. However, the elevation of urinary NAG index was found in some ciclosporin-treated patients with normal serum Cr. The elevation of NAG index without the elevation of urinary FDP occurred in ciclosporin nephrotoxicity. The SDS electrophoresis of urinary proteins, urinary FDP, and urinary NAG index can be useful parameters for monitoring ciclosporin nephrotoxicity.     

Renal tubular damage after renal stone treatment

Summary 50 patients were studied with respect to renal tubular damage related to open operative, percutaneous and extracorporeal shock wave treatment of renal stones. Preoperative and postoperative urinary N-acetyl-glucosaminidase (NAG) levels were measured as a marker of renal damage. There was no significant evidence of renal tubular damage in patients who underwent a conventional or percutaneous nephrolithotomy; urinary NAG excretion was significantly increased after ischaemic surgery. After extracorporeal shock wave lithotripsy (ESWL) serum NAG levels increased, probably because a damage of the white blood cells in cutaneous and renal circulation, but a slight increase of urinary NAG excretion could suggest a mild renal tubular damage especially in case of more than 2,000 shocks.     

Urinary excretion rate of guanidinoacetic acid as a new marker in hypertensive renal damage

This study was undertaken to evaluate the relation between the urinary excretion of guanidinoacetic acid (GAA) and other substances in hypertensive patients (6 with borderline hypertension and 29 with hypertension) and 12 normal controls. In 10 of the hypertensive patients, GAA was measured before and after 4 weeks of treatment with calcium entry blocker. In hypertensive patients the rate of GAA urinary excretion was 43.5 +/- 17-4 micrograms/min, which was much lower than in the controls (77.2 +/- 35.9 micrograms/min) (p less than 0.01). There was no significant difference among these groups in creatinine clearance (CCr), serum creatinine (Cr), beta 2-microglobulin (BMG) or in the urinary excretion of BMG, N-acetyl-D-glucosaminidase (NAG) or radiosensitive microalbumin (mAlb). The urinary excretion rate of GAA was positively correlated with CCr (r = 0.62; p less than 0.01), and negatively correlated with mean blood pressure (r = -0.49; p less than 0.01). Finally, the GAA excretion was significantly correlated with urinary NAG (r = 0.24; p less than 0.05) and serum BMG (r = -0.31; p less than 0.05), but not with urinary mAlb (r = 0.12; p less than 0.05). Ten hypertensive patients followed for 4 weeks attained their ultimate mean blood pressure reduction after treatment (from 119.3 +/- 8.0 to 101.7 +/- 13.5 mm Hg; p less than 0.001), but the GAA/Cr ratio in the urinary excretion was significantly elevated (from 0.054 +/- 0.016 to 0.070 +/- 0.02; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)     

Enzymatic evaluation of renal damage caused by different therapeutic procedures for kidney stone disease

In an attempt to evaluate renal injury relative to open surgery, percutaneous nephrolithotripsy (PCN) and extracorporeal shock wave lithotripsy (ESWL) were studied in 52 patients with renal calculus disease. Preoperative and postoperative urinary levels of N-acetyl-glycosaminidase (NAG), a sensitive marker of renal tubular damage, were studied. No significant changes were noted in posttreatment urinary NAG values among patients who underwent ESWL or PCN. Although statistically nonsignificant, a constant mild increase of urinary NAG was observed after PCN, that has to be evaluated with long-term follow-up studies. The shock wave number or power in cases treated with ESWL as well as the number of renal punctures in the PCN group did not change the effect on renal tubular function. Diabetics and patients with chronic renal disease treated by ESWL did not show any significant change in posttreatment urinary NAG levels. In contrast to that, all patients treated by open surgery had significant, intense and prolonged increase of the postoperative NAG values, especially those treated by ischaemic nephrolithotomy. Comparing the three different therapeutic modalities, open surgical procedures had the most significant effect on renal function and this difference was statistically significant. We therefore suggest that ESWL does not endanger renal function, while open surgery must be reserved for selected cases.     

孟鲁司特钠联合双嘧达莫对儿童过敏性紫癜肾损害的保护作用

目的探讨孟鲁司特钠联合双嘧达莫对过敏性紫癜（henoch-schonlein purpura,HSP）患儿肾损害的。肾保护作用。方法将146例尿常规检查正常的HSP患儿分为3组,对照组（A组）46例给予维生素C、芦丁等常规治疗;B组57例在A组常规治疗基础上加用孟鲁司特钠治疗;C组43例在常规治疗的基础上加用孟鲁司特钠和双嘧达莫治疗。3组分别于入院时,治疗后第1个月检测尿免疫球蛋白G（immunoglobulin,IgG）、微量白蛋白（micro-albumin,mAlb）、转铁蛋白（transferrin,TRF）、Ct1微球蛋白（a1-microglobulin,a1-MG）、p2微球蛋白（p2-microglobulin,β2-MG）和N-乙酰-β-氨基葡萄糖苷酶（N-acetyl-β-D-glucosaminidase,NAG）的含量。随访6个月;比较3组血尿和（或）蛋白尿的发生率、发病时间及临床分型。结果A组治疗前后TRF、mAlb、82-MG、NAG含量比较,差异有统计学意义（P〈0．01,P〈0．05）;B、C组治疗后第1个月IgG、mAlb、TRF、α1-MG、B2-MG和NAG均较治疗前降低,除α1-MG外,差异有统计学意义（P％0．01）;B、C组治疗后第1个月IgG、mAlb、TRF、α1-MG、B2-MG和NAG均较A组降低,除Ⅸ1-MG外,差异有统计学意义（P〈0．01）;治疗后第1个月各组间IgG、mAb、TRF、α1-MG、82-MG和NAG比较,除a1-MG外,差异有统计学意义（P〈0．01）;B、C组血尿和（或）蛋白尿的发病率、发病时间及临床分型与A组比较,差异有统计学意义（P〈0．05,P〈0．01）。结论应用孟鲁司特钠或孟鲁司特钠联合双嘧达莫治疗HSP,对HSP早期肾损害均有保护作用,可能对HSP肾损害有预防作用。孟鲁司特钠联合双嘧达莫对过敏性紫癜肾损害进行早期干预疗效优于单用孟鲁司特钠。     

Serum cystatin C and urinary enzymes as screening markers of renal dysfunction in diabetic patients

Background: In clinical practice, the assessment and follow-up of early renal dysfunction is important in diabetic nephropathy. Therefore, this study was designed to determine whether the serum cystatin C (Cys C) and activities of some tubular enzymes could be used as screening markers for renal dysfunction in diabetic patients. Methods: Serum Cys C levels and urinary activities of N-acetyl-b-D-glucosaminidase (NAG), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) and whole blood glycolyse hemoglobin (HbA1C) were measured in 56 diabetic patients and 20 healthy subjects (controls). The results were compared with serum creatinine (Cr) and creatinine clearance (CCr), which were measured and estimated with the Cockcroft-Gault formula (CCG) and 24-hr urine microalbuminuria (MAU). We examined the influence of albuminuria, HbA1C and CCr levels of patients on the levels of the analyzed parameters. Sensitivity and specificity for the diagnosis of renal impairment were calculated by a receiver operating characteristics (ROC) curve for serum Cys C, Cr and urinary enzymes. Results: In normoalbuminurics, only serum Cys C levels and urinary NAG activities were found elevated as compared to controls. In addition to the elevation of serum Cys C levels and urinary activities of NAG, urinary ALP and LDH activities were also found elevated in microalbuminurics. Serum Cys C levels and urinary NAG, ALP, LDH activities started to increase above the normal range when CCr declined and while serum Cr was in the normal range in patients with 50相似文献   

Urinary NAG in children with urolithiasis,nephrocalcinosis, or risk of urolithiasis

A crucial role for cell-crystal interactions in the development of urolithiasis (UL) and nephrocalcinosis (NC) was previously observed in experiments with different cell lines mimicking renal epithelial cells. It was found that such cell-crystal interactions lead to tubular damage and/or or dysfunction. To find further proof for these observations, we measured the urinary N-acetyl--d-glucosaminidase (NAG) excretion, a marker of proximal tubular damage, in children with UL or NC and in children with an increased risk of UL. We enrolled 142 children aged 4–16 years (mean 9.67±3.40 years), with 50 children having UL, 30 children with a history of UL (ULH), 20 patients with NC, 34 children with secondary hyperoxaluria (HyOx), and 8 children with idiopathic hypercalciuria (HC). Normal urinary NAG/Cr values were determined in a group of 70 healthy children aged 4–16 years (mean 10.06±3.97 years). The urinary NAG activity was measured using a colorimetric method and the results were expressed as molar creatinine (Cr) ratios. The highest median NAG/Cr ratios were found in children with UL plus hematuria (0.72 U/mmol) and in children with UL (0.67 U/mmol) or NC (0.48 U/mmol), which were all significantly higher than those in controls (0.28 U/mmol, P<0.001 and P<0.05). The NAG/Cr ratios were increased above the upper normal reference interval of 0.63 U/mmol (95th percentile) in 28 of 50 (56%) children with UL and in 9 of 20 (45%) children with NC. Although the ULH group also had significantly higher median NAG/Cr ratios (0.36 U/mmol) compared with controls, the NAG/Cr ratio was only elevated in 4 of 30 (13%) patients. NAG values in children with secondary HyOx or HC were not different from controls. No correlation was found between the NAG/Cr ratios and the urinary excretion of oxalate or calcium. In conclusion, UL or NC may result in proximal tubular injury, which is rather the consequence of disease activity and of the mechanical influence of calculi, than of the metabolic background. The mechanism of cell damage in these conditions however, seems to be complex. Neither HyOx nor HC alone were sufficient to induce severe tubular damage expressed as an increase in NAG excretion in our patients.     

Potential biomarkers for the early detection of acute kidney injury after percutaneous nephrolithotripsy

This study aims to investigate the role of urinary biomarkers in the determination of the potential risks of renal parenchymal tubular damage in adult patients who underwent percutaneous nephrolithotomy (PNL) with the indication of renal stone. A randomized and prospective controlled study was performed between June and December 2013. We enrolled 29 consecutive patients with renal calculi?>?2?cm and who underwent PNL, as well as 47 healthy control subjects. Urine samples, including 2 h before surgery, 2 and 24 h after surgery were collected from the patient group. Freshly voided urine samples were collected from the control group. Kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-glucosaminidase (NAG), and liver-type fatty acid binding protein (LFABP) levels were measured from these urine samples. The mean KIM-1/Cr value that measured 24 h after the operation was statistically significant, higher than its preoperative (preop) level (p?= 0.045). A significant difference was detected between the mean preop and postoperative (postop) 24 h NAG/Cr values (p?< 0.001). Also, postop 24 h NGAL/Cr levels were statistically significant, higher than its preop levels (p?= 0.013). According to the comparison of preop and postop levels, an increase in LFABP/Cr values secondary to surgical intervention was observed without any statistically significant difference. Besides the LFABP/Cr levels do not change after percutaneous kidney surgery, KIM-1/Cr, NAG/Cr, and NGAL/Cr levels increase postop period, especially at 24 h. Further studies with a larger series and repeated measurements should be performed to clarify if they can be used to demonstrate renal damage after percutaneous surgery or not.     

氧自由基、炎症因子在结石患者肾小管损伤中的作用

目的探讨氧自由基和炎症因子共同作用促进肾结石形成。方珐选择40例肾结石患者（志愿者）和健康无结石志愿者30例，分别留尿生化分光光度法测NAG、7-GT、Cr、SOD、MDA和NO，放免法测Bz—MG和TNFa。结果结石组尿中反映肾脏损伤的特异性指标NAG、rGT和Bz—MG显著升高，两组之间存在统计学差异（P〈O．05）。结石组血中损伤相关因子TNF—a和MDA值高于健康对照组，两组之间有显著性差异（P〈0．05）；血中保护相关因子SOD值显著低于健康对照组（P〈0．05）。培论尿路结石患者尿中Bz—MG、7-GT和NAG水平显著升高，表明尿路结石形成过程中的确导致肾小管功能损伤，而且其升高可能与氧化损伤和局部炎症反应有关。