Nakamura S, Azuma T
2nd Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Nihon Jinzo Gakkai Shi. 1992 Mar;34(3):273-7.
Urine albumin was determined in patients with chronic glomerular injuries with normal renal function, who had shown positive test of microhematuria but negative test of proteinuria at any time of our renal clinic. The subjects were divided into 4 groups: (1) IgA nephropathy (IgAN); 13, (2) asymptomatic hematuria (AS); 18, (3) nephrotic syndrome in complete remission (CR); 21 and (4) age matched normal subjects; 44. Urine albumin concentration was measured with radioimmunoassay in the ambulatory urine, and, in some cases, in the urine obtained after supine position for 30 minutes to demonstrate the effect of ambulatory physical movement on albumin excretion. Also urine alanine aminopeptidase (AAP) and N-acetyl-beta-D-glucosaminidase (NAG) were estimated by monitoring the absorbance of products released by the enzyme, as the indices of tubular function. The results indicated that urine albumin were 8.4 +/- 7.3 mg/g Cr (Mean +/- SD) in normal subjects, and 8.8 +/- 8.9 mg/g Cr in CR (vs. controls: N.S.), 18.9 +/- 14.5 mg/g Cr in AS (P = 0.0071), and 22.2 +/- 14.9 mg/g Cr in IgAN (P = 0.0063). The albumin excretion had no relation with the grade of microhematuria and also with the ambulatory physical movement. Moreover, AAP and NAG excretion in each group had shown no significant alterations. These results indicate that urine albumin increases in IgAN and AS with normal renal function and with microhematuria alone, but not in CR. Urine albumin is probably glomerular origin, since no abnormality is found in the tubular functions.
对肾功能正常的慢性肾小球损伤患者测定尿白蛋白,这些患者在我们肾脏门诊的任何时间点尿潜血试验呈阳性但蛋白尿试验呈阴性。研究对象分为4组:(1) IgA肾病(IgAN);13例,(2) 无症状血尿(AS);18例,(3) 肾病综合征完全缓解(CR);21例,以及(4) 年龄匹配的正常受试者;44例。采用放射免疫分析法测定动态尿液中的尿白蛋白浓度,在某些情况下,还测定仰卧位30分钟后收集的尿液中的尿白蛋白浓度,以证明动态身体活动对白蛋白排泄的影响。此外,通过监测酶释放产物的吸光度来估计尿丙氨酸氨基肽酶(AAP)和N-乙酰-β-D-葡萄糖苷酶(NAG),作为肾小管功能指标。结果表明,正常受试者尿白蛋白为8.4±7.3mg/g肌酐(均值±标准差),CR组为8.8±8.9mg/g肌酐(与对照组相比:无显著性差异),AS组为18.9±14.5mg/g肌酐(P = 0.0071),IgAN组为22.2±14.9mg/g肌酐(P = 0.0063)。白蛋白排泄与血尿分级以及动态身体活动均无关。此外,每组中AAP和NAG排泄均未显示出显著变化。这些结果表明,在肾功能正常且仅有镜下血尿的IgAN和AS患者中尿白蛋白增加,但CR患者未增加。尿白蛋白可能来源于肾小球,因为未发现肾小管功能异常。