Schäffer Péter, Molnár László, Lukász Péter, Máttyus István, Verebély Tibor, Szabó Antal
Semmelweis Egyetem, Altalános Orvostudományi Kar, I. sz. Gyermekgyógyászati Klinika, Budapest.
Orv Hetil. 2002 Sep 15;143(37):2135-9.
Renal tissue, and tubules are rich in enzymes but enzyme measurement in the urine as diagnostic parameters in renal diseases have not yet been generally accepted as routine procedures.
To study urinary enzyme excretion in childhood obstructive uropathy and compares the diagnostic efficiency of them.
Excretion of the enzymes alkaline phosphatase (ALP), gamma-glutamyltransferase (gamma-GT), N-acetyl-beta-D-glucosaminidase (NAG) and leucine aminopeptidase (LAP) has been investigated in urine of 34 children suffering from obstructive uropathy and in 31 healthy controls by photometric kinetic analysis using synthetic substrates.
Urinary excretion of both enzymes significantly increase--2-10 times higher than normal controls--indicates tubular damage. In this study the following relations were found in specificity and in sensitivity: ALP < LAP < gamma-GT < NAG.
Elevated urinary enzyme excretion may be helpful in identifying upper tract obstruction, which if left untreated may cause progressive renal deterioration. It has a role in helping to determine the surgical correction or can be safely followed without fear of parenchymal damage.
肾组织及肾小管富含酶类，但将尿中酶的测定作为肾脏疾病的诊断参数尚未被普遍接受为常规检查方法。
研究儿童梗阻性尿路病患者的尿酶排泄情况，并比较其诊断效率。
采用合成底物通过光度动力学分析法，对34例梗阻性尿路病患儿及31例健康对照者尿液中的碱性磷酸酶（ALP）、γ-谷氨酰转移酶（γ-GT）、N-乙酰-β-D-氨基葡萄糖苷酶（NAG）和亮氨酸氨肽酶（LAP）的排泄情况进行了研究。
两种酶的尿排泄量均显著增加，比正常对照组高2至10倍，表明肾小管受损。在本研究中，发现了以下特异性和敏感性关系：ALP < LAP < γ-GT < NAG。
尿酶排泄量升高可能有助于识别上尿路梗阻，若不治疗可能导致进行性肾脏损害。它有助于确定手术矫正方案，或者可以安全地进行随访而不用担心实质损害。
