Dudek-Dyczkowska Dorota, Jałowiecki Przemysław, Rudner Robert, Duława Jan
Oddziału Klinicznego Anestezjologii i Intensywnej Terapii Katedry Anestezjologii i Intensywnej Terapii, Slaskiej Akademii Medycznej w Katowicach.
Wiad Lek. 2003;56(9-10):395-401.
The aim of this study was to assess the influence of some anaesthesia methods on renal function in patients with no clinical and laboratory symptoms of nephropathy. The activity of various parts of the nephron was evaluated on the basis of the urinary excretion of albumins (marker of renal glomeruli function), beta-2-microglobulins (marker of proximal tubule function) and Tamm-Horsfall protein (marker of distal tubule function). 45 patients were divided into three groups, basing on the kind of anaesthesia: "O"--general, "P"--spinal and "N"--local. The patients who were routinely found to have no signs of nephropathy showed no dysfunction of renal glomeruli and distal or proximal tubule as determined by the urinary excretion of albumins, Tamm-Horsfall protein and beta-2-microglobulins prior to the operation. Different anaesthesia techniques had no effect on the urinary excretion of beta-2-microglobulins. In contrast to local and spinal anaesthesia, general anaesthesia significantly increased the urinary excretion of albumins. General, spinal as well as local anaesthesia significantly decreased the urinary excretion of Tamm-Horsfall protein. The decrease in the excretion of this glycoprotein suggests that all types of anaesthesia techniques may influence the function of the distal part of nephron.
本研究旨在评估某些麻醉方法对无肾病临床及实验室症状患者肾功能的影响。基于白蛋白（肾小球功能标志物）、β-2-微球蛋白（近端小管功能标志物）及Tamm-Horsfall蛋白（远端小管功能标志物）的尿排泄情况，对肾单位各部分的活性进行评估。45例患者根据麻醉类型分为三组：“O”组——全身麻醉，“P”组——脊髓麻醉，“N”组——局部麻醉。术前经常规检查无肾病迹象的患者，其白蛋白、Tamm-Horsfall蛋白及β-2-微球蛋白的尿排泄情况显示肾小球及远端或近端小管均无功能障碍。不同麻醉技术对β-2-微球蛋白的尿排泄无影响。与局部麻醉和脊髓麻醉相比，全身麻醉显著增加了白蛋白的尿排泄。全身麻醉、脊髓麻醉及局部麻醉均显著降低了Tamm-Horsfall蛋白的尿排泄。这种糖蛋白排泄的减少表明，所有类型的麻醉技术都可能影响肾单位远端的功能。
