尿NAG测定用于严重烧伤后肾功能损害的监测

采用荧光基质４－甲基伞型酮－β－Ｄ－基葡萄糖苷荧光法，动态观察了５９例严重烧伤病人尿ＮＡＧ酶活性。结果表明，严重烧伤后尿ＮＡＧ酶活性显著升高，持续在较高水平，伤后４１天仍显著高于正常对照。尿ＮＡＧ与ＢＵＮ、Ｃｒ呈显著正相关，与Ｃｃｒ呈显著负相关。尿ＮＡＧ活性增加与烧伤面积和烧伤深度密切相关。肾功能衰竭组尿ＮＡＧ显著升高。动态观察尿ＮＡＧ活性可了解病变的轻重、病程归转及影响因素，为临床判定严重烧伤病人肾损伤提供一个敏感有用的非创伤性方法。     

尿液NAG变化对狼疮性肾炎活动性评价意义

目的 :观察狼疮性肾炎患者尿液N -乙酰 - β -D -氨基葡萄糖苷酶 (N -acetal- β -D -glucosaminidase,NAG)的变化 ,探讨其与狼疮活动度的关系。方法 :回顾性分析 5 6例狼疮性肾炎的临床资料。结果 :其中 5 2例狼疮性肾炎患者尿液NAG增高 ,敏感度 92 .8% ,行肾组织病理检查 38例中有 2 6例为Ⅳ型狼疮性肾炎患者 ,其尿液NAG均见明显增高 ,治疗后随着狼疮活动的控制 ,尿液NAG明显下降 (P <0 .0 1)。而活动度相对较低的Ⅱ型狼疮性肾炎 ,尿液NAG仅增高程度显著低于Ⅳ型狼疮性肾炎患者 (P <0 .0 1)。结论 :尿液NAG的变化可以作为评价狼疮活动程度及治疗效果的一个指标。     

中枢神经系统疾病患者脑脊液NAG活性的临床观察

研究目的探讨脑脊液NAG活性变化与中枢神经系统疾病的关系。设计分别对化脓性脑膜炎(化脑)、结核性脑膜炎(结脑)、病毒性脑膜炎(病毒脑)和脑血栓形成等四组患者和对照者的脑脊液进行NAG活性测定,并对测定结果进行统计学处理。研究单位一附院检验科患者及其它参与者:本组患者共 57例,男30例,女27例,年龄3～60岁。其中化脑24例,结脑5例、病毒脑5例,脑血栓形成23例。对照者为无神经系统疾患的外科小手术患者,共12例,男10例,女2例,年龄18～25岁。处理方法取脑脊液0.1ml与10μmol/L对硝基—N—乙酰—β—D—氨基葡萄糖苷水溶液0.5ml混合置37℃水温中保存待测。测定及结果用分光光度法测定NAG活性,结果显示:化脑、结脑、病毒脑、脑血栓形成和对照组脑脊液NAG活性分别为9.9±6.2、4.5±2.6、3.7±2.0、3.9±化脑组CSF NAG活性有极显著性差异(P<0.001),其它组无显著性差异(P>0.05)。结论化脑患者脑脊液NAG活性明显升高。     

职业性铅接触尿N-乙酰-β-D-氨基葡萄糖苷酶活性的变化

目的研究铅接触者尿N-乙酰-β-D.氨基葡萄糖苷酶(NAG)活性变化。方法对某蓄电池厂135名铅作业工人及52名非接触者进行了尿铅含量及尿NAG活性测定。结果接触组工人尿NAG[(13.91±1.62)U/gCr]活性明显高于对照组[(7.82±1.55)U/gCr]。随着尿铅水平升高,尿NAG活性有升高趋势。接铅1～3年组尿NAG活性开始上升,7年以上明显增加。结论尿NAG活性似可作为铅致肾损害的早期生物标志物。     

尿酶与微量白蛋白联合检测对2型糖尿病早期肾损伤的诊断价值

目的探讨尿酶与微量白蛋白联合检测对2型糖尿病早期肾损伤的诊断价值。方法收集我院门诊住院病人随意尿,以肌酐比值报告的方式,进行微量白蛋白（mAlb）、N-乙酰-β-氨基葡萄糖苷酶（NAG）、β-半乳糖苷酶（GAL）检测。NAG、GAL用速率法;mAlb用免疫透射比浊法;肌酐（Cr）用苦味酸不去蛋白法;尿蛋白定性用醋酸加热法。结果158例2型糖尿病组各项指标均值均高于对照组,差异非常显著（P〈0.01）;尿蛋白定性阳性率23.42%;而mAlb、NAG、GAL增高率分别为49.36%、66.46%和64.56%,总增高率77.80%;其中121例尿蛋白阴性标本,3项指标高于对照组的检出率为74.38%。患病1年内mAlb、NAG、GAL阳性检出率分别为43.33%、60.00%和60.00%。结论随意尿为无创伤性标本,尿酶与微量白蛋白联合检测并用肌酐比值法报告,对2型糖尿病早期肾损伤的诊断很有价值。     

尿检筛查在粥样硬化性肾动脉狭窄肾损害中的初步分析

目的探讨尿NAG/UCr(尿N-乙酰-β-D-氨基葡萄糖苷酶/尿肌酐)及尿液巨噬细胞阳性率应用于ARAS(粥样硬化性肾动脉狭窄)筛查及监测支架置入术治疗效果的可能性。方法检测17例ARAS患者、20例合并≥2项动脉粥样硬化危险因素的非ARAS动脉粥样硬化疾病患者及20例同年龄健康者的尿NAG/UCr及尿液巨噬细胞阳性率,观察上述指标在三组中的分布变化及ARAS患者支架置入术前后尿NAG/UCr、尿液巨噬细胞阳性率的变化;检测ARAS患者的肾脏病理变化。结果①ARAS患者肾活检提示ARAS肾损害的重要发生机制是肾小管间质炎性反应进展至纤维化;②尿NAG/UCr及尿液巨噬细胞阳性率能反映ARAS肾小管间质的受损情况,对监测ARAS进展及观察支架术治疗的效果有一定帮助,但与ARAS狭窄程度不一定平行。结论尿NAG/UCr及尿液巨噬细胞阳性率可作为预测ARAS活动的指标,提示控制炎症治疗和放置血管内支架的时机。     

Inhibitors of calpain activation (PD150606 and E-64) and renal ischemia-reperfusion injury

Calpain activation has been implicated in the development of ischemia-reperfusion (I-R) injury. Here we investigate the effects of two inhibitors of calpain activity, PD150606 and E-64, on the renal dysfunction and injury caused by I-R of rat kidneys in vivo. Male Wistar rats were administered PD150606 or E-64 (3mg/kg i.p.) or vehicle (10%, v/v, DMSO) 30min prior to I-R. Rats were subjected to bilateral renal ischemia (45min) followed by reperfusion (6h). Serum and urinary biochemical indicators of renal dysfunction and injury were measured; serum creatinine (for glomerular dysfunction), fractional excretion of Na(+) (FE(Na), for tubular dysfunction) and urinary N-acetyl-beta-d-glucosaminidase (NAG, for tubular injury). Additionally, kidney tissues were used for histological analysis of renal injury, immunohistochemical analysis of intercellular adhesion molecule-1 (ICAM-1) expression and nitrotyrosine formation. Renal myeloperoxidase (MPO) activity (for polymorphonuclear leukocyte infiltration) and malondialdehyde (MDA) levels (for tissue lipid peroxidation) were determined. Both PD150606 and E-64 significantly reduced the increases in serum creatinine, FE(Na) and NAG caused by renal I-R, indicating attenuation of renal dysfunction and injury and reduced histological evidence of renal damage caused by I-R. Both PD150606 and E-64 markedly reduced the evidence of oxidative stress (ICAM-1 expression, MPO activity, MDA levels) and nitrosative stress (nitrotyrosine formation) in rat kidneys subjected to I-R. These findings provide the first evidence that calpain inhibitors can reduce the renal dysfunction and injury caused by I-R of the kidney and may be useful in enhancing the tolerance of the kidney against renal injury associated with aortovascular surgery or renal transplantation.     

NAG infection inRana temporaria after suppression of the normal intestinal microflora

Frogs (Rana temporaria) with disturbed biocenosis of their intestinal microflora produced by a combination of tetracycline and hypothermia (+4°C) were used as the experimental model. The animals were infected perorally with a culture of NAG vibrios and then kept under clinical observation and tested bacteriologically, immunomorphologically, and by electron microscopy. The possible lymphohematogenous pathway of generalization of infection was demonstrated and some causes of the prolonged persistance of vibrios in the animals' bodies are discussed.Institute of Human Morphology, Academy of Medical Sciences of the USSR, Moscow. Translated from Byulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 87, No. 5, pp. 393–396, May, 1979.     

体外循环和非体外循环冠脉搭桥术对患者肾功能的影响

目的研究体外循环和非体外循环冠脉搭桥术对肾功能的影响。方法24例接受冠脉搭桥术的患者分为两组,每组12例。A组为体外循环下冠脉搭桥组,B组为非体外循环下冠脉搭桥组。观察两组患者术前(T0)、手术结束(T1)、术后2 h(T2)和术后24 h(T3)时间点肾小球和肾小管功能的改变。结果体外循环冠脉搭桥组尿微量白蛋白与尿肌酐比值(m-A lb/Cr)、尿N-乙酸-β-D氨基葡萄糖苷酶(NAG)浓度组内各点相比,T1与T0比较差异有统计学意义(P<0.05)。非体外循环冠脉搭桥组尿m-A lb/Cr和NAG在T1时间点较体外循环冠脉搭桥组明显降低(P<0.05)。结论体外循环冠脉搭桥术可引起可逆性的肾功能早期损害。非体外循环冠脉搭桥术较体外循环冠脉搭桥术对肾功能损害明显减轻。     

过敏性紫癜性肾炎患儿肾小管功能检测

目的：探讨尿视黄醇结合蛋白（RBP）、尿胱蛋白酶抑制剂C（CysC）、尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）的测定在判断小儿过敏性紫癜性肾炎（APN）肾小管-间质损伤中的临床意义。方法：用ELISA方法和酶-底物直接显色法测定24例APN患儿（肾穿报告提示急性病变10例,急性＋慢性病变10例,另4例木见肾小管间质病变）尿液中RBP、CysC、NAG的含量,分析3者的相关性以及与肾小管-病理损伤的关系。结果：急性病变患儿与急性＋慢性病变患儿RBP、CysC、NAG含量差异无统计学意义。24例患者中尿RBP／Cr和CysC／Cr异常百分率分别为58．3％（14／24）、50．0％（12／24）,且两者有相关性（r=0．877,P〈0．0001）。尿NAG的异常百分率为75．0％（18／24）,与前两者无关。RBP、CysC、NAG在不同肾小球病理分级中差异均有统计学意义。结论：尿RBP、CysC、NAG3者联合检测对早期诊断和全面监测肾小管-间质损伤具有重要的临床意义。