四氯化碳、黄磷、三硝基甲苯引起肝纤维化及某些生化指标变化规律的研究

本研究分别给四组大鼠注射CCl_4、P_4、TNT及纯生油,进行亚慢性实验,在不同的时间处死动物,测定血清及肝组织NAG、CP、MAO、羟脯氨酸和肝组织病理观察。CCl_4染毒3周后就发生肝纤维化;P_4和TNT染毒12周后才发生肝纤维化。血清中NAG、CP及肝组织中NAG、羟辅氨酸含量在肝纤维化早期即有明显升高,其中血清NAG、CP与肝组织中羟脯氨酸含量有明显正相关关系。血清NAG、CP似可以用作了解肝纤维化情况的指标。     

糖尿病微血管病变患者血清CysC、RBP及尿NAG的变化与糖尿病肾病发展的关系

目的 探讨糖尿病肾微血管病变患者血清胱抑素C(cystatin C,CysC)、视黄醇结合蛋白(retinol binding protein,RBP)及尿N-乙酰-β-D氨基葡萄糖苷酶(N-acetyl beta-D Glucosaminidase,NAG)的水平变化与糖尿病肾病病变程度的关系.方法 本研究选取30例2型糖尿病肾病患者(尿微量白蛋白＜ 14.29mg/L)作为A组、选取30例2型糖尿病肾病患者(尿微量白蛋白≥14.29mg/L)作为B组、30例2型糖尿病肾病引发尿毒症患者作为C组、30例体检正常研究对象作为D组,比较四组患者血清中CysC、RBP、NAG的差异.结果 A、B、C、D四组研究对象的CysC、RBP及尿NAG水平差异均具有统计学意义(P＜0.01);组间比较,A、B、C组CysC、RBP及尿NAG与D组比较均显著的高于D组,差异均具有统计学意义(P＜0.05);A、B组患者的CysC、RBP及尿NAG与C组比较显著低于C组,差异具有统计学意义(P＜0.05);A组患者的CysC、RBP及尿NAG与B组比较显著低于B组,差异具有统计学意义(P＜0.05).结论 糖尿病肾病患者随着病变程度不断加重,CysC、RBP及尿NAG水平呈明显的上升趋势.     

乌司他丁对瓣膜置换术患者肾脏的保护作用

目的探讨乌司他丁对心脏瓣膜置换术患者肾脏的保护作用。方法53例心脏瓣膜置换术患者随机分为两组,试验组(U组,n=30),对照组(C组,n=23)。试验组术中予乌司他丁2万U/kg静脉注射,对照组给生理盐水。于术前30min,主动脉阻断前5min,主动脉开放后5min,手术结束时,以及术后第1、3、5天查尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿肌酐(Cr),求两者比值NAG/Cr,测血BUN、Cr,并记录尿流率及术后速尿使用总量。结果主动脉开放后5min、手术结束时、术后第1天试验组尿NAG/Cr值低于对照组(P<0.05);尿流率高于对照组(P<0.05);试验组术后速尿使用总量少于对照组(P<0.05);两组间血清BUN、Cr差异无统计学意义。结论心脏瓣膜置换术中使用乌司他丁有利于肾脏保护。     

血清视黄醇结合蛋白（RBPs）和尿N-乙酰-β-D氨基葡萄糖苷酶（NAG）在糖尿病肾病诊断中的价值

目的 探讨血清视黄醇结合蛋白（retinol binding proteins,RBPs）和尿N-乙酰-β-D氨基葡萄糖苷酶（N-acetyl-β-D-glucosaminidase,NAG）在糖尿病肾病（diabetic nephropathy,DN）诊断中的价值.方法 选取2010年5月～2012年5月我院进行治疗的105例2 型糖尿病患者,以尿微量白蛋白（mALB）/尿肌酐（UCr）比值将患者分为研究组和对照组.结果 研究组血清RBPs、尿NAG水平与对照组比较显著增高,差异有统计学意义（P〈0.05）.研究组血清RBPs阳性为24.53%,对照组为3.85%,两组比较,差异有统计学意义（P〈0.05）.研究组尿NAG阳性率为30.19%,对照组为7.69%,两组比较,差异有统计学意义（P〈0.05）.105例 2 型糖尿病患者尿mALB与血清RBPs、尿NAG水平呈正相关关系（r=0.539,r=0.447,P〈0.05）.结论 在糖尿病早期阶段,肾小管功能会受到损害,血清RBPs和尿NAG作为早期DN诊断的敏感指标,具有重要价值.     

Elevated tubular proteinuria, albuminuria and decreased urinary N-acetyl-β-D-glucosaminidase activity following unilateral total ureteral obstruction in rats

Urinary tubular proteinuria and N-acetyl-β-d-glucosaminidase (NAG) activity has not yet been studied after unilateral total ureteral obstruction (UTO). The aim of the study was (1) to evaluate in a longitudinal study (7 weeks) the behaviour and the potential clinical value of tubular proteinuria and urinary NAG activity after UTO; (2) to study the physiopathology of the non-obstructed contralateral kidney by using these two different markers of tubular damage. Methods: in 28 female, adult Wistar rats (UTO: n= 16, sham: n= 12), tubular proteinuria and urinary NAG activity were measured before and 1 and 5 weeks after surgery. Results: a significant (P < 0.01) increase in tubular proteinuria/creatinine ratio and urinary creatinine and a decrease in urinary NAG activity was found 1 week after UTO. All parameters normalized after 6 weeks. Albuminuria increased progressively (P < 0.01) during the study. Conclusion: tubular proteinuria increases during the first week following UTO in rats. The initial increase of low molecular weight proteins following UTO is not due to tubular damage as no parallel increase of urinary NAG was found. We suggest an initial tubular overperfusion with primary urine, due to an increased single nephron glomerular filtration and overruling the reabsorption capacity of the proximal tubules. Received: 1 December 1997 / Accepted: 2 March 1998     

The effect of endogenous parathyroid hormone,exogenous calcitonin,and dibutyryl cyclic AMP on urinary excretion of N-acetyl-β-D-glucosaminidase

Urinary excretion of N-acetyl--D-glucosaminidase (NAG) transiently increases after PTH(1–34) infusion in idiopathic hypoparathyroidism (IHP) but this response is impaired in pseudohypoparathyroidism (PHP) type I. We investigated the effects of endogenous PTH, exogenous calcitonin (CT), and dibutyryl cAMP (DBcAMP) on urinary excretion of NAG. Urinary NAG excretion in 14 patients with primary hyperparathyroidism (1^oHPT) was more than in normal subjects (P<0.001) and decreased after parathyroidectomy (P<0.01). Urinary NAG excretion increased after the infusion of 1.5 MRC/kg of eel CT in eight normal subjects (P<0.001), two patients with IHP, and a patient with PHP type Ib but not in a patient with PHP type Ia. The increases of urinary NAG excretion by CT and by PTH(1–34) were positively correlated with the increases of urinary cAMP excretion (r=0.752; P<0.001 and r=0.534; P<0.002, respectively). Urinary NAG excretion increased after DBcAMP infusion in five normal subjects (P<0.01), two patients with IHP, and two with PHP type I. The increase of urinary NAG by 6.0 mg/kg of DBcAMP was more than by 2.5 mg/kg of DBcAMP in normal subjects (P<0.01). The increase of urinary NAG by 2.5 mg/kg of DBcAMP in PHP type I was comparable with that by 6.0 mg/kg in normal subjects, suggesting a hyperresponsiveness to DBcAMP in PHP type I. Urinary excretion of NAG is a useful indicator of renal tubular responsiveness to PTH and CT. Cyclic AMP-dependent mechanism is probably involved in PTH and CT-induced increase in urinary excretion of NAG.     

不同海拔高度高原红细胞增多症患者尿白蛋白和N-乙酰-β-D-氨基葡糖苷酶的排泄变化及其机理的探讨

目的:研究不同海拔高度高原红细胞增多症(HAPC)患者尿白蛋白(ALB)和N-乙酰-β-D-氨基葡糖苷酶(NAG)的排泄变化及其与红细胞生物物理特性的关系。方法:对两个海拔高度(刚察县3300m、甘德县4080m)HAPC患者检测了尿ALB、NAG、红细胞滤过指数(EFl)、红细胞超氧化物歧化酶(SOD)活性和血浆丙二醛(MDA)含量。结果:HAPC患者尿ALB、NAG、血浆MDA含量和EFI明显高于同海拔健康组, 而红细胞SOD活性明显低于同海拔健康组;随海拔升高, HAPC患者尿ALB和NAG排泄量、血浆MDA含量和EFI明显升高, 相关和多因素逐步回归分析表明, 尿ALB和NAG与EFI呈正相关, 而与血浆MDA含量、红细胞SOD、血色素、红细胞、红细胞压积水平无明显相关。结论:红细胞变形能力(ED)对尿ALB和NAG存在独立影响, HAPC患者机体脂质过氧化反应增强, 可能导致ED降低, 造成肾内微循环障碍, 可能是尿ALB和NAG含量产生增多的病理生理机制之一。