糖尿病患者尿酶变化及意义

应用速率法检测６０例糖尿病（ＤＭ）患者的尿Ｎ－乙酰－β－Ｄ－氨基葡萄糖苷酶（ＮＡＧ）、碱性磷酸酶（ＡＬＰ）、ｒ－谷氨酰转肽酶（ＧＧＴ）活性。结果显示ＤＭ患者尿ＮＡＧ活性明显升高，且与尿白蛋白排泄率（ＵＡＥＲ）呈正相关，并可先于ＵＡＥＲ的增加而出现。提示尿ＮＡＧ活性测定可作为间接反映肾小球滤过膜功能、筛查糖尿病早期肾病的一项敏感指标。     

微量NAG酶释放法鉴定牛血清促进细胞生长的活性

目的　检查牛血清促进细胞生长的活性。方法　微量NAG酶释放法。结果　在同一实验条件下 ,试验血清 (990 5 0 7,990 40 2 )与对照血清 (990 40 5 )对促进K5 6 2细胞生长的活性没有明显差别 ,但血清的促进细胞生长活性随着储存时间的增加而降低 ,如试验血清 (970 6 2 1)。结论　利用微量NAG酶释放法可以筛查新生牛血清促进细胞生长的活性     

血胱抑素C及尿酶对糖尿病肾病早期诊断的意义

目的探讨血胱抑素C(CysC)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿微量白蛋白(mALB)对糖尿病肾病早期诊断的临床意义。方法选择我院60例糖尿病患者,其中尿蛋白阴性的患者31例为观察1组,阳性29例为观察2组;同时选择体检中心同期同年龄段正常体检者40例为对照组,测定糖尿病组和正常对照组血胱抑素C(CysC)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿微量白蛋白(mALB),同时测定尿肌酐(Cr)。结果分别以CysC、NAG/Cr、mALB/Cr表示。结果观察1组与观察2组CysC、NAG/Cr、mALB/Cr指标明显高于对照组,检测结果比较差异明显,具有统计学意义P<0.05;观察2组CysC、NAG/Cr、mALB/Cr指标明显高于观察1组,2组结果比较差异明显,具有统计学意义P<0.05。结论 CysC、NAG/Cr、mALB/Cr能较准确反应早期糖尿病患者肾损害程度的临床检测指标,三者联合检测是早期诊断糖尿病肾病的敏感指标。     

用速率法测定尿NAG活性及其临床应用

本文报道用５５０型全自动生化分析仪，以速率法测定尿ＮＡＧ活性及本室尿ＮＡＧ活性的正常参考范围；并对可能影响尿ＮＡＧ活性的尿ＰＨ，尿素浓度等进行了干扰试验及分析。     

Influence of renal compensatory hypertrophy on mitochondrial energetics and redox status

A reduction in functional renal mass is common in numerous renal diseases and aging. The remaining functional renal tissue undergoes compensatory growth primarily due to hypertrophy. This is associated with a series of physiological, morphological and biochemical changes similar to those observed after uninephrectomy. Previous work showed that compensatory renal cellular hypertrophy resulted in an increase in susceptibility to several drugs and environmental chemicals and appeared to be associated with oxidative stress. Compensatory renal cellular hypertrophy was also associated with increases in mitochondrial metabolic activity, uptake of glutathione (GSH) across renal plasma and mitochondrial inner membranes, and intracellular GSH concentrations. Based on these observations, we hypothesize that the morphological, physiological and biochemical changes in the hypertrophied kidney are associated with marked alterations in renal cellular energetics, redox status and renal function in vivo. In this study, we used a uninephrectomized (NPX) rat model to induce compensatory renal growth. Our results show alterations in renal physiological parameters consistent with modest renal injury, altered renal cellular energetics, upregulation of certain renal plasma membrane transporters, including some that have been observed to transport GSH, and evidence of increased oxidative stress in mitochondria from the remnant kidney of NPX rats. These studies provide additional insight into the molecular changes that occur in compensatory renal hypertrophy and should help in the development of novel therapeutic approaches for patients with reduced renal mass.     

尿肾损伤分子-1在急性肾损伤诊断中的临床价值

目的探讨尿肾损伤分子-1(Kidney injury molecule-1,Kim-1)在急性肾损伤诊断中的敏感性及临床价值。方法选择2010年1月至2011年6月在我科住院的急性肾损伤患者58例作为病例组,健康体检者20例为对照组。尿Kim-1、微量白蛋白(mALB)测定采用酶联免疫吸附法(ELISA),尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)测定采用对硝基苯酚(PNP)比色法。结果急性肾损伤组患者尿液中的Kim-1、NAG、mALB的测定浓度明显高于对照组,差异具有统计学意义(P<0.01),我们通过ROC曲线、诊断试验结果显示:尿Kim-1曲线下面积为0.956,95%可信区间为0.910～1.001,较尿NAG、mALB更具有敏感性(P<0.001),两组间患者年龄及男女比例差异均无统计学意义(P>0.05)。结论尿Kim-1在急性肾损伤诊断中起着重要的作用,检测尿Kim-1的浓度可以成为急性肾损伤患者无创并有效的检测手段,有助于急性肾损伤的早期监测,对预防急性肾损伤的发生、发展具有重要的临床价值。     

RENAL TUBULAR PEPTIDE CATABOLISM IN CHRONIC VASCULAR REJECTION

Chronic vascular rejection (CR) is the commonest cause of renal transplant loss, with few clues to etiology, but proteinuria is a common feature. In diseased native kidneys, proteinuria and progression to failure are linked. We proposed a pathogenic role for this excess protein at a tubular level in kidney diseases of dissimilar origin. We demonstrated in both nephrotic patients with normal function and in those with failing kidneys increased renal tubular catabolisman and turnover rates of a peptide marker, Aprotinin (Apr), linked to increased ammonia excretion and tubular injury. These potentially injurious processes were suppressed by reducing proteinuria with Lisinopril. Do similar mechanisms of renal injury and such a linkage also occur in proteinuric transplanted patients with CR, and if so, is Lisinopril then of beneficial value? We now examine these aspects in 11 patients with moderate/severe renal impairment (⁵¹CrEDTA clearance 26.2 ± 3.3 mL/min/1.73m²), proteinuria (6.1 ± 1.5 g/24 h) and biopsy proven CR. Lisinopril (10–40 mg) was given daily for 2 months in 7 patients. Four others were given oral sodium bicarbonate (Na HCO₃) for 2 months before adding Lisinopril. Renal tubular catabolism of intravenous ^99mTc-Apr (Apr^* 0.5 mg, 80 MBq), was measured before and after Lisinopril by γ-ray renal imaging and urinary radioactivity of the free radiolabel over 26 h. Fractional degradation was calculated from these data. Total 24 h urinary N-acetyl-β-glucoaminidase (NAG) and ammonia excretion in fresh timed urine collections were also measured every two weeks from two months before treatment. After Lisinopril proteinuria fell significantly (from 7.8 ± 2.2 to 3.4 ± 1.9 g/24 h, p < 0.05). This was associated with a reduction in metabolism of Apr^* over 26 h (from 0.5 ± 0.05 to 0.3 ± 0.005% dose/h, p < 0.02), and in fractional degradation (from 0.04 ± 0.009 to 0.02 ± 0.005/h, p <0.01). Urinary ammonia fell, but surprisingly not significantly and this was explained by the increased clinical acidosis after Lisinopril, (plasma bicarbonate fell from 19.1 ± 0.7 to 17.4 ± 0.8 mmol/L, p <0.01), an original observation. Total urinary NAG did fall significantly from a median of 2108 (range 1044–3816) to 1008 (76–2147) μmol/L, p < 0.05. There was no significant change in blood pressure or in measurements of glomerular hemodynamics. In the 4 patients who were given Na HCO₃ before adding Lisinopril, both acidosis (and hyperkalemia) were reversed and neither recurred after adding Lisinopril. These observations in proteinuric transplanted patients after Lisinopril treatment have not been previously described.     

NAG infection in tadpoles of Rana temporaria

In a series of experiments 2250 tadpoles were infected with three strains of NAG vibrios. It can be concluded from the results of bacteriological and pathomorphological electron-microscopic and light-optical investigations that during the first 2 days the animals develop and recover from an acute infection, but the vibrios later persist for a long time in the body of the tadpoles and are excreted with the feces into the surrounding medium.Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 82, No. 7, pp. 841–843, July, 1976.     

铅性肾损害效应生物标志物β2-MG、NAG、RBP的相关影响因素研究

目的研究β2-MG、NAG、RBP在铅性肾损害评价中的影响因素。方法采用相关分析或分组比较法。结果β2-MG、NAG、RBP与年龄、接铅工龄呈明显正相关（r依序为：0．221、0．230、0．433,0．359、0．419、O．365）,β2-MG、RBP与血铅呈明显正相关（r依序为：O．419、0．354）;另外三个指标间也有明显相关关系。结论应用RBP、β2-MG、NAG评价铅性肾损害时,应注意个体的年龄、接铅工龄的影响,并注意与血铅及其各指标间的相互关系。