Uto I, Ishimatsu T, Hirayama H, Ueda S, Nishi K, Tsuruta J, Kambara T
Department of Urology, Kumamoto University Medical School, Japan.
Eur Urol. 1991;19(4):315-8. doi: 10.1159/000473650.
The excretion of urinary Tamm-Horsefall protein (THP) was determined by enzyme-linked immunosorbent assay and glomerular filtration rate (GFR) was calculated with technetium-99m diethylenetriamine pentacetic acid (99mTc-DTPA) renal scintigraphy in 26 consecutive patients with primary vesicoureteral reflux (VUR) before and after antireflux surgery. Wide variations of urinary THP excretion and GFR were seen in all grades of VUR. On the basis of the relationship between urinary THP excretion and GFR before the surgery, patients were divided into three groups. The first group (group A, n = 8) had normal urinary THP values and normal values of GFR. The second group (group B, n = 11) had high THP excretion and moderately decreased GFR, the third group (group C, n = 7) had normal urinary THP excretion and severely decreased GFR. In group A, urinary THP values remained normal and GFR improved in all patients after surgery. In group B, GFR improved when urinary THP dropped immediately, but GFR did not improve when urinary THP remained high after surgery. In group C, GFR did not improve and urinary THP continued to be low or tended to drop again after the surgery. The results suggested that serial measurements of urinary THP excretion and GFR by 99mTc-DTPA renal scintigraphy before and after antireflux surgery are useful for the evaluation of renal function in patients with primary VUR.
采用酶联免疫吸附测定法测定26例原发性膀胱输尿管反流（VUR）患者抗反流手术前后尿中Tamm-Horsfall蛋白（THP）的排泄量，并通过锝-99m二乙三胺五乙酸（99mTc-DTPA）肾闪烁显像计算肾小球滤过率（GFR）。所有等级的VUR患者尿THP排泄量和GFR均有广泛变化。根据手术前尿THP排泄量与GFR之间的关系，将患者分为三组。第一组（A组，n = 8）尿THP值正常，GFR值正常。第二组（B组，n = 11）THP排泄量高，GFR中度降低，第三组（C组，n = 7）尿THP排泄量正常，GFR严重降低。A组所有患者术后尿THP值保持正常，GFR改善。B组中，尿THP立即下降时GFR改善，但术后尿THP仍高时GFR未改善。C组术后GFR未改善，尿THP持续偏低或有再次下降趋势。结果表明，抗反流手术前后通过99mTc-DTPA肾闪烁显像连续测量尿THP排泄量和GFR，有助于评估原发性VUR患者的肾功能。
