N-乙酰-β-D-氨基葡萄糖苷酶和β2-微球蛋白：特发性肾病综合征的预后标志物

N-acetyl-beta-D-glucosaminidase and beta2-microglobulin: prognostic markers in idiopathic nephrotic syndrome.

作者信息

Fede C, Conti G, Chimenz R, Ricca M

机构信息

Nephrology and Dialysis Division, Social and Preventive Medical Pediatric Institute, University of Messina, Italy.

出版信息

J Nephrol. 1999 Jan-Feb;12(1):51-5.

PMID:10203005

Abstract

Increased urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG) and beta2-microglobulin (beta2M) is considered a marker of tubulo-interstitial disease. This study assessed urinary excretion of NAG and beta2M in children with nephrotic syndrome (NS), 14 with cortico-sensitive nephrotic syndrome (CSNS), five with cortico-resistant NS (CRNS) and 30 healthy controls matched for sex and age. At onset urinary excretion of NAG was significantly higher in children with CSNS than controls (p=0.0001) but during remission values were superimposable. Conversely in CRNS at onset urinary excretion of NAG and beta2M was significantly higher than CSNS and remained unchanged at the end of steroid treatment (p < 0.05 and p < 0.01). Urinary NAG values in CSNS were correlated with proteinuria (r = 0.63), serum total proteins (r = -0.54), serum albumin (r = -0.55) and serum cholesterol (r = 0.67). These data suggest that urinary excretion of NAG and beta2M may be useful as a marker of tubular dysfunction in nephrotic syndromes which often characterises cortico-resistant patients.

摘要

N-乙酰-β-D-氨基葡萄糖苷酶（NAG）和β2-微球蛋白（β2M）尿排泄增加被认为是肾小管间质疾病的一个标志物。本研究评估了肾病综合征（NS）患儿、14例皮质激素敏感型肾病综合征（CSNS）患儿、5例皮质激素抵抗型NS（CRNS）患儿以及30名年龄和性别匹配的健康对照者的NAG和β2M尿排泄情况。发病时，CSNS患儿的NAG尿排泄显著高于对照组（p = 0.0001），但缓解期数值重叠。相反，CRNS患儿发病时NAG和β2M的尿排泄显著高于CSNS，且在类固醇治疗结束时保持不变（p < 0.05和p < 0.01）。CSNS患儿的尿NAG值与蛋白尿（r = 0.63）、血清总蛋白（r = -0.54）、血清白蛋白（r = -0.55）和血清胆固醇（r = 0.67）相关。这些数据表明，NAG和β2M的尿排泄可能作为肾病综合征肾小管功能障碍的一个标志物有用，而肾小管功能障碍常是皮质激素抵抗型患者的特征。