Hayashi M, Tomobe K, Hirabayashi H, Hoshimoto K, Ohkura T, Inaba N
Department of Obstetrics and Gynecology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
Am J Med Sci. 2001 Mar;321(3):168-72. doi: 10.1097/00000441-200103000-00002.
Little is known about when the urinary excretion of a combination of N-acetyl-beta-D-glucosaminidase (NAG) and beta2-microglobulin (beta2MG) concentration [relative to creatinine (Cr)] reaches maximal values during uncomplicated normotensive pregnancy. This study was thus designed to analyze when urinary excretion of biochemical parameters was increased during normotensive pregnancy.
NAG, beta2MG, total protein, albumin, and Cr were simultaneously measured in random (untimed) midstream urine samples from 22 healthy nonpregnant women and from 82 normotensive pregnant women (22 in gestational week 20, 25 in week 30, and 35 in week 37).
NAG/Cr and beta2MG/Cr ratios were significantly higher (P < 0.01-0.05) in the normotensive pregnant women in gestational week 30 than in the nonpregnant control subjects and normotensive pregnant women in gestational week 20. The NAG/Cr and beta2MG/Cr ratios showed maximal values in gestational week 30. The total protein/Cr ratio was significantly higher in gestational weeks 20, 30, and 37 than in the control subjects. The albumin/Cr ratio was significantly higher in women in gestational week 30 and 37 than in women in gestational week 20 and in the control subjects.
The excretion of both NAG and beta2MG relative to Cr was increased and showed the maximal values in gestational week 30 during normotensive pregnancy. The increase in a tubular enzyme (NAG) might be caused by renal tubular damage, and that in a low molecular weight protein (beta2MG) might result from decreased renal tubular reabsorption. These findings suggest that renal tubular damage and reabsorption dysfunction were increased in gestational week 30.
对于在无并发症的正常血压妊娠期间，N - 乙酰 - β - D - 氨基葡萄糖苷酶（NAG）和β2 - 微球蛋白（β2MG）浓度组合（相对于肌酐（Cr））的尿排泄何时达到最大值，人们了解甚少。因此，本研究旨在分析正常血压妊娠期间生化参数的尿排泄何时增加。
对22名健康未孕女性和82名正常血压孕妇（妊娠20周22名、30周25名、37周35名）的随机（不定时）中段尿样本同时进行NAG、β2MG、总蛋白、白蛋白和Cr的检测。
妊娠30周的正常血压孕妇中NAG/Cr和β2MG/Cr比值显著高于未孕对照受试者以及妊娠20周的正常血压孕妇（P < 0.01 - 0.05）。NAG/Cr和β2MG/Cr比值在妊娠30周时达到最大值。妊娠20周、30周和37周时总蛋白/Cr比值显著高于对照受试者。妊娠30周和37周女性的白蛋白/Cr比值显著高于妊娠20周女性和对照受试者。
在正常血压妊娠期间，相对于Cr，NAG和β2MG的排泄均增加，并在妊娠30周时达到最大值。肾小管酶（NAG）的增加可能是由肾小管损伤引起的，而低分子量蛋白质（β2MG）的增加可能是由于肾小管重吸收减少所致。这些发现表明妊娠30周时肾小管损伤和重吸收功能障碍增加。
