Sánchez Navarro M R, Fernández-Conde M E, Blanco Martín S, Samaniego C
Departamento de Bioquímica, Hospital Universitario San Cecilio, Granada.
An Med Interna. 2002 Sep;19(9):449-52.
The aim of this study was to test the utility of serum alkaline phosphatase isoenzymes determination from patients with renal insufficiency.
Serum levels of alkaline phosphatase isoenzymes were determined in a group of 58 patients: 22 of them suffering acute renal insufficiency (ARI) and 36 with chronic renal failure (CRF) undergoing regular hemodialysis, results obtained were compared from a population of 30 healthy adults. Intestinal, bone, liver, macromolecular and intestinal variant isoenzymes, were separated by electrophoresis on agarose gel and quantified using a densitometer.
Were found a significant increase the total alkaline phosphatase activity in both pathologic groups (p < 0.05 in ARI and p < 0.01 in CRF). Isoenzymatic profiles showed: increase of the bone fraction (p < 0.05 in ARI and p < 0.001 in CRF), decrease of the liver isoenzyme (p < 0.001) in both groups, macromolecular fraction elevated in acute patients (p < 0.05) and a significant increase of the intestinal and intestinal variant isoenzyme in the chronic patients (p < 0.001).
The renal insufficiency modified the normal distribution of alkaline phosphatase isoenzymes and the study of their serum levels could be an effective non-invasive marker, for the evaluation of bone disease and intestinal disorders associated with renal failure.
本研究旨在检测血清碱性磷酸酶同工酶测定对肾功能不全患者的实用性。
测定了58例患者的血清碱性磷酸酶同工酶水平：其中22例患有急性肾功能不全（ARI），36例接受定期血液透析的慢性肾衰竭（CRF）患者，将所得结果与30名健康成年人的群体进行比较。通过琼脂糖凝胶电泳分离肠道、骨、肝、大分子和肠道变异同工酶，并使用密度计进行定量。
在两个病理组中均发现总碱性磷酸酶活性显著增加（ARI中p<0.05，CRF中p<0.01）。同工酶谱显示：两组中骨组分均增加（ARI中p<0.05，CRF中p<0.001），肝同工酶均降低（p<0.001），急性患者的大分子组分升高（p<0.05），慢性患者的肠道和肠道变异同工酶显著增加（p<0.001）。
肾功能不全会改变碱性磷酸酶同工酶的正常分布，对其血清水平的研究可能是评估与肾衰竭相关的骨病和肠道疾病的一种有效的非侵入性标志物。
