Timokhov V S, Kazakov I V, Toritsina L K, Ipat'eva E I, Ametov A S
Urol Nefrol (Mosk). 1991 May-Jun(3):53-7.
Neopterin is a biochemical marker of cellular mediated immune reactions and may be used in elucidating the cause of acute renal failure. 9 patients (6 males, 3 females) aged 23 to 56 years suffering from a severe form of the disease were examined. A continuous arteriovenous hemofiltration was used as a treatment with exchanging 29.2 +/- 2.0 (14-65) kg of fluid during 24 hours. The patients' diet included protein and amino acids of 1.2-1.5 g/kg of body weight, 35-45 Kcal/kg of body weight per 24 hours with meal and parenteral infusions. 4 patients died. Contents of neopterin in the plasma of the healthy equaled to 6.8 +/- 03 (3.4-11.3) nmol/l (radioimmunoassay; Henning; Berlin, GmbH). In patients with acute renal failure plasma neopterin contents were increased, i.e. 130.0 +/- +/- 9.6 (48.2-200.2) nmol/l and in two thirds of the cases and correlated with creatinine levels (r = + 0.60 +/- 0.17; p less than 0.05; n = 23), thus showing a simultaneous influence of anuria and continuous arteriovenous hemofiltration on a neopterin pool amount at the same time, in patients with tropical malaria and hemotransfusion shocks (2 cases), the neopterin contents were extremely high and did not correlate with the creatinine level. During continuous hemofiltration at a rate of 21.6 +/- 1.3 (15.9-36.9) ml/min neopterine clearance was 17.2 +/- 2.1 (6.7-36.2) ml/min. Neopterin hyperproduction after blood transfusion suggests an immune conflict as a possible cause of acute renal failure.
新蝶呤是细胞介导免疫反应的生化标志物，可用于阐明急性肾衰竭的病因。对9例年龄在23至56岁之间患有严重疾病的患者（6例男性，3例女性）进行了检查。采用持续动静脉血液滤过进行治疗，24小时内置换液体29.2±2.0（14 - 65）千克。患者的饮食包括每24小时每千克体重1.2 - 1.5克的蛋白质和氨基酸，通过进餐和肠外输注每24小时每千克体重35 - 45千卡热量。4例患者死亡。健康人血浆中新蝶呤含量为6.8±0.3（3.4 - 11.3）纳摩尔/升（放射免疫测定法；亨宁公司；柏林，德国）。急性肾衰竭患者血浆中新蝶呤含量升高，即130.0±9.6（48.2 - 200.2）纳摩尔/升，三分之二的病例中与肌酐水平相关（r = + 0.60±0.17；p＜0.05；n = 23），这表明无尿和持续动静脉血液滤过同时对新蝶呤池量有影响，在热带疟疾和输血性休克患者（2例）中，新蝶呤含量极高且与肌酐水平无关。在以21.6±1.3（15.9 - 36.9）毫升/分钟的速率进行持续血液滤过时，新蝶呤清除率为17.2±2.1（6.7 - 36.2）毫升/分钟。输血后新蝶呤过度产生提示免疫冲突可能是急性肾衰竭的原因。
