尿石症患者血浆及尿中环磷酸腺苷和环磷酸鸟苷的测定及其意义

本文采用放射免疫法测定了31例尿石症患者晨空腹血浆和24小时尿的cAMP和cGMP值,以此推算出滤过、清除和肾源性cAMP和cGMP值,并与20例健康人对照。结果发现尿石症者cAMP的几项指标均升高。血浆中cGMP降低,清除和肾源性cGMP增高,cAMP与cGMP值均呈正相关,推测cGMP在结石形成中的作用与cAMP相似。部分结石病人存在甲状旁腺机能亢进(简称甲旁亢),cAMP和cGMP可作为诊断尿石症患者甲旁亢的辅助指标,其中肾源性及血浆cAMP/cGMP值较敏感。测定值宜采用肾小球滤过率修正。

Determination and Significance of Cyclic AMP andCyclic GMP in the Plasma and Urineof Patients with Urinary Calculi

The values of cyclic AMP and cycic GMP in fasting plasma and 24-hour urine of 31 patients with urinary stone and of 20 normal control subjects were determined by radioimmunoassay so as to calculate the values of filtered, clearance and nephrogenous cyclic AMP and cyclic GMP.It was found that all parameters of cyclic AMP are significantly elevated in stone patients group. Stone patients have significantly lower-than-normal plasma cyclic GMP, significantly higher-than-normal clearance cyclic GMP and nephrogenous cyclic GMP. There are positive correlations betwesn plasma, urinary and nephrogenous cyclic AMP and cyclic GMP. It is supposed that the function of cyclic GMP is similar to that of cyclic AMP in the formation of stone.Some of the patients have primary or secondary hyper parathyroidism. Cyclic AMP and GMP are indirect parameters in the diagnosis of hyperparathyroidism in stone patients. Nephrogenous cyclic AMP or GMP and plasma cAMP/cGMP are more sensitive parameters. The values of urinary and nephrogenous cyclic AMP and cyclic GMP should be expressed as nmol/100mlGF.