尿N-乙酰-β-D-氨基葡萄糖苷酶、尿微量白蛋白、尿β2-微球蛋白、尿α1-微量球蛋白检测对糖尿病肾病的早期诊断价值及临床意义

目的探讨尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）检测对早期糖尿病肾病的诊断价值。方法将95例受试者分为健康对照组（为门诊健康体检人群）和病例组（均为2型糖尿病患者）。采用对硝基苯酚（PNP）比色法和酶联免疫法分别检测病例组及健康对照组的尿NAG、mALB、β2．MG、α1—MG的测定含量,并对检测结果进行比较及统计学分析。结果例组各项指标阳性率及检测含量均高于健康对照组,病例组四项检测指标阳性率为尿NAG（95．0％）、mALB（84．2％）、α1-MG（50．0％）、β2-MG（47．5％）,差异具有统计学意义（P〈0．001）。尿NAG的敏感性最高（P〈0．05）。结论尿NAG检测对早期糖尿病肾病更具有敏感性,可以作为糖尿病肾病的早期诊断及疗效观察的有效指标。     

尿N-乙酰-β-D-氨基葡萄糖苷酶、尿微量白蛋白、尿β2-微球蛋白、尿α1-微量球蛋白检测对糖尿病肾病的早期诊断价值及临床意义

目的 探讨尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)检测对早期糖尿病肾病的诊断价值.方法 将95例受试者分为健康对照组(为门诊健康体检人群)和病例组(均为2型糖尿病患者).采用对硝基苯酚(PNP)比色法和酶联免疫法分别检测病例组及健康对照组的尿NAG、mALB、β2-MG、α1-MG 的测定含量,并对检测结果进行比较及统计学分析.结果 例组各项指标阳性率及检测含量均高于健康对照组,病例组四项检测指标阳性率为尿NAG(95.0%)、mALB(84.2%)、α1-MG(50.0%)、β2-MG(47.5%),差异具有统计学意义(P<0.001).尿NAG的敏感性最高(P<0.05).结论 尿NAG检测对早期糖尿病肾病更具有敏感性,可以作为糖尿病肾病的早期诊断及疗效观察的有效指标.     

尿N-乙酰-β-D-氨基葡萄糖苷酶、尿微量白蛋白、尿β2-微球蛋白、尿α1-微量球蛋白检测对糖尿病肾病的早期诊断价值及临床意义

目的 探讨尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)检测对早期糖尿病肾病的诊断价值.方法 将95例受试者分为健康对照组(为门诊健康体检人群)和病例组(均为2型糖尿病患者).采用对硝基苯酚(PNP)比色法和酶联免疫法分别检测病例组及健康对照组的尿NAG、mALB、β2-MG、α1-MG 的测定含量,并对检测结果进行比较及统计学分析.结果 例组各项指标阳性率及检测含量均高于健康对照组,病例组四项检测指标阳性率为尿NAG(95.0%)、mALB(84.2%)、α1-MG(50.0%)、β2-MG(47.5%),差异具有统计学意义(P<0.001).尿NAG的敏感性最高(P<0.05).结论 尿NAG检测对早期糖尿病肾病更具有敏感性,可以作为糖尿病肾病的早期诊断及疗效观察的有效指标.     

尿微量蛋白联合尿酶诊断肾脏轻微损害

目前肾脏疾病的实验室诊断多以尿蛋白、血尿素氮、血肌酐、尿红细胞形态作为主要指标 ,但难以发现轻微肾损害。尿微量白蛋白 (m AL B)、转铁蛋白 (TRF)、视黄醇结合蛋白 (RBP)、N-乙酰 - β- D-氨基葡萄糖苷酶 (NAG)的单项或两项检测在以往报道中多见 ,三项检测偶见 ,尿 m AL B、TRF、RBP对糖尿病早期肾病 [1～ 3 ] ,m AL B、TRF对高血压患者早期肾损害诊断已有报道[4,5 ] ,但这四项指标联合检测诊断肾脏轻微损害尚未见报道。我们采用尿 m AL B、TRF、RBP、NAG联合检测法 ,以诊断肾脏轻微损害。1　材料与方法1.1　研究对象…     

尿微量蛋白系列测定诊断早期糖尿病肾病

糖尿病(DM)与高血压、肥胖、高脂血症称为“死亡四重奏”，发病率逐年增高，糖尿病肾病(DN)是其远期并发症之一。DN早期为可逆性，进入临床期后为不可逆性，所以早期诊断对其预后意义重大。现将尿微量蛋白系列测定诊断早期DN综述如下。     

尿mALB和尿NAG酶的联合检测在肾结石中的临床价值

目的 探讨尿mALB和尿NAG酶水平对肾结石引起的肾功能损害的早期诊断价值.方法 检测60例临床诊断为肾结石患者的尿微量白蛋白（mALB）和尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）等指标,并与30例正常对照组比较.结果 30例正常对照组尿mALB为11.19±4.83mg/L,尿NAG酶为5.14±2.55U/L.60例肾结石组,各指标以超过正常上限（x±2s）为阳性,尿mALB单独有19例阳性,尿NAG酶单独有13例阳性,二指标均阳性有17例,与对照组比较结果均存在显著差异（P〈0.01）.结论 尿mALB和尿NAG酶活性的联合检测,对肾结石引起的肾功能损伤起到早期诊断的临床价值.     

尿微量蛋白与糖尿病肾病的关系

目的探讨尿微量清蛋白（MAU）、尿β2微球蛋白（β2-m）与糖尿病肾病（DN）的关系。方法MAU采用免疫荧光双抗体夹心法、尿β2-m采用放射免疫分析法（RIA）对30例健康人及86例糖尿病（DM）患者进行MAU、尿β2-m含量测定,并进行相关分析。结果单纯DM组MAU、尿β2-m含量分别为（14．8±8．2）、（0．168±0．107）mg／L,与对照组相比增高不明显（P〉0．05）,DN组MAU、尿β2-m含量分别为（153±102）、（0．814±0．512）mg／L,明显高于对照组,差异有统计学意义（P〈0．01）,对照组、单纯DM组、DN组MAU、尿β2-m浓度呈递增趋势。结论MAU、尿β2-m含量随着DN的发生以及严重程度逐渐增高,可作为早期诊断DN较敏感的指标,对于监测早期DN的发生和病情发展程度有重要意义。     

尿微量蛋白检测对糖尿病肾病的早期诊断价值

糖尿病肾病是糖尿病的严重并发症.近年研究表明,在糖尿病肾病早期,患者都有不同程度的尿微量蛋白的排出增加,如尿白蛋白(Alb),α1-微球蛋白(α 1M)和免疫球蛋白(IgG),转铁蛋白(TRF).为了解各种蛋白的增加程度,我们采用免疫散射比浊法测定了65例糖尿病患者的Alb、α1M、IgG及TRF.     

尿液联合检测对肾损害性疾病的早期诊断价值及临床应用

目的探讨尿N-乙酰-β—D-氨基葡萄糖苷酶（NAG）、尿微量白蛋白（mALB）、尿β2-微球蛋白（β2-MG）、尿α1-微量球蛋白（α1-MG）的检测对肾损害性疾病的早期诊断价值及临床意义。方法将231例受试者分为A组（健康对照组）和B组（住院患者病例组）。分别检查两组尿NAG、mALB、β2-MG、α1-MG的测定含量,并对检测结果进行统计分析。结果B组（住院患者病例组）检测结果显著高于A组（健康对照组）,差异具有统计学意义,（P〈0．001）,住院患者病例组四种检测项目尿NAG、mALB、β2-MG、α1—MG所测到的阳性率分别为82．3％、74．0％、42．5％、41．9％。结论尿NAG、mALB、β2-MG、α1-MG的检测对早期肾损害较敏感,可以作为肾损害性疾病的早期监测、疗效观察及预后判断的有效指标。     

Enhanced urinary albumin excretion after 35 weeks of gestation and during labour in normal pregnancy.

This study reports on the urinary albumin to creatinine ratio during normal pregnancy, with special emphasis on the pre-delivery and labour periods. Albumin was determined in single voided urine specimens obtained from healthy non-pregnant women (n = 16) and healthy pregnant women (n = 203; Groups A and B, 133 females examined during clinic visits and presentation at obstetric department; Group C, 70 females examined during labour) by radioimmunoassay (RIA). The mean ratio (+/- SD) for albumin/creatinine (A/Cr) in non-pregnant women was 1.46 +/- 0.32 mg mmol-1 Cr. Thus, 2.10 mg mmol-1 Cr (mean+2 SD) was considered to be the upper limit of normo-albuminuria. During pregnancy, 73% of the women (97 out of 133, Groups A and B) excreted less than or equal to 2.10 mg mmol-1 Cr. During the first 35 weeks of gestation, 30 of 34 pregnant women (88%) excreted less than or equal to 2.10 mg mmol-1 Cr, the mean being 0.93 +/- 0.64 mg mmol-1 Cr (median 1.0 mg mmol-1). During 36-42 weeks of gestation, the median A/Cr was 1.93 mg mmol-1 Cr (range 0.43-12.16) and 32 of 99 (32%) had values greater than 2.10 mg mmol-1 Cr, an increase of more than two-fold (p less than 0.031) compared with the first 35 weeks. During labour, 61% of non-haematuric urines (33 of 54, Group C) were greater than 2.10 mg mmol-1 Cr, being 125% greater (p less than 0.006) than that observed during pregnancy. Thus in normal pregnancy, A/Cr is increased during the late period of pregnancy and during labour.     

Urinary excretion of some proteins and enzymes during normal pregnancy

Total protein (TP), albumin (Alb), transferrin (TRF), retinol-binding protein (RPB), N-acetyl-beta-glucosaminidase (NAG), alanine aminopeptidase (AAP), gamma-glutamyltransferase (GGT), and creatinine (Cr) were measured in random (untimed) urine samples from 29 nonpregnant women and from pregnant subjects (11 in the first trimester, 34 in the second, and 37 in the third). The excretion of TP, Alb, TRF, NAG, and AAP (relative to creatinine) and the RBP concentration were all higher (P less than or equal to 0.05) in the second and third trimesters compared with values for the nonpregnant controls. The GGT/Cr ratio was significantly higher only in the third trimester. The increase in low-molecular-mass proteins and tubular enzymes suggests that at least part of the increase in Alb, TRF, and TP results from decreased tubular reabsorption. We conclude that excretion of both high- and low-molecular-mass proteins is increased during pregnancy.     

类风湿关节炎患者尿微量白蛋白与NAG测定及其意义

笔者对60例尿蛋白定性和肾功能正常的类风湿关节炎患者及60例健康人分别进行尿微量白蛋白、NAG的含量测定，结果类风湿关节炎组尿微量白蛋白和NAG均比对照组明显升高。提示：类风湿关节炎患者肾小球及肾小管有损伤，尿微量白蛋白与NAG测定比尿定性检查更为灵敏，可作为类风湿关节炎患者早期肾损害的敏感指标。     

The urinary excretion of the nucleosides pseudouridine and 1-methylinosine during normal menstrual cycle

The excretion levels of the nucleosides pseudouridine and 1-methylinosine were determined by gas-liquid chromatography in 24-h urine specimens from young women during normal menstrual cycle. These nucleosides are derived primarily from transfer RNA and their excretion reflects the turnover of tRNA. The excretion levels were found to be essentially unaltered by the cycle and the average excretion values with standard deviations were 0.70 ± 0.078 and 0.051 ± 0.011 mg/kg/24 h for pseudouridine and 1-methylinosine, respectively.     

Excretion of urinary enzymes in normal pregnancy

OBJECTIVES: To study the pattern of excretion of enzymes in urine during normal pregnancy. DESIGN AND METHODS: Primigravidae, with uncomplicated pregnancies, were followed up throughout gestation. Urine samples were collected from them and activities of alanine aminopeptidase (AAP), gamma-glutamyl transferase (GGT), acid phosphatase (ACP) and N-acetyl-beta-d-glucosaminidase (NAG) activities in urine were estimated. RESULTS: Small but significant increases were found in the activities of AAP and NAG excreted through the course of pregnancy. The changes seen in excretion of ACP and GGT were not statistically significant. CONCLUSIONS: Changes in excretion of ACP and GGT may be useful indicators of renal dysfunction in pregnancy, as their activities did not vary significantly through the course of normal pregnancy.     

Selective increase in the urinary excretion of protein 1 (Clara cell protein) and other low molecular weight proteins during normal pregnancy

The effect of normal pregnancy on the tubular transport of proteins has been studied by measuring four low molecular weight (Mr) proteins in the urine of pregnant women: protein 1 (a recently discovered urinary protein identical to Clara cell protein), β₂-microglobulin, retinol-binding protein and α₁-microglobulin. The urinary excretion of albumin and β-N-acetylglucosaminidase was also determined. One hundred and fourteen women with uncomplicated pregnancy were examined: 22 in the first trimester, 42 in the second and 50 in the third trimester. They were compared to 40 age-matched non-pregnant women. The urinary excretion of the four low Mr proteins was significantly increased during the second and third trimester of pregnancy. During the last trimester, the mean relative increases in the urinary excretion of these proteins ranged from 2.8 to 15.6 and prevalences of elevated values from 25 to 46%. This rise in low Mr urinary protein excretion was particularly important in some pregnant women, representing (e.g. for protein 1) more than a 100-fold increase above normal. The urinary excretion of β-N-acetyl-D-glucosaminidase was also increased during pregnancy but the albuminuria remained stable. These changes in low Mr urinary proteins were reversible after delivery and most likely resulted from a transient decrease in the reabsorptive capacity of the proximal tubule associated with an increase of the filtered load. However, some women excreted high amounts of protein 1 which could not be accounted for by a decreased tubular reabsorption and which might originate from a secretion by the urogenital tract.     

Urinary excretion of N-acetyl-beta-D-glucosaminidase in normal and complicated pregnancy

The urinary excretion of N-acetyl-beta-D-glucosaminidase activity, a sensitive indicator of renal tubular injury, was monitored during and after pregnancy. During normal pregnancy, enzymuria increased progressively to levels 3-4 times above normal in the third trimester. In diabetic mothers, enzyme excretion followed a similar pattern, but was generally higher than in uncomplicated pregnancies. Also in preeclampsia, enzymuria tended to be higher than in normal pregnancy. Enzyme excretion normalized about a year after normal pregnancies, but remained elevated in diabetic subjects and in patients who had developed preeclampsia. This latter finding indicates that marginal persistent renal damage may occur during preeclampsia.     

Effect of pefloxacin on the urinary excretion of rifampicin

The effect of pefloxacin on the urinary excretion of rifampicin was investigated in 5 healthy volunteers between the ages of 20 and 35 years. The investigation was carried out in 2 different phases, with a 1-week drug washout separating the phases. Each subject received 600 mg rifampicin with 350 mL of water. After 1 week, the subjects were given 600 mg rifampicin plus 500 mg pefloxacin with 350 mL of water. Urinary levels of rifampicin were measured spectrophotometrically for the 2 phases from 0 to 72 hours. Coadministration of rifampicin with pefloxacin led to 20.1% urinary recovery of rifampicin. The increased rifampicin excretion rate following pefloxacin coadministration is supported by the competitive liver clearance between rifampicin and pefloxacin, which favors pefloxacin and causes rifampicin secretion, thus increasing its elimination through the kidney. Pefloxacin increases the absorption and urinary excretion of rifampicin by decreasing the gastrointestinal motility through chelation mechanisms.