Komatsu Y
Department of Medicine, Tokyo Women's Medical College, Japan.
Nihon Jinzo Gakkai Shi. 1990 Nov;32(11):1243-51.
Abnormalities in albumin metabolism in nephrotic syndrome are still controversial. In an attempt to clarify the pathogenesis of the alteration in albumin metabolism in nephrotic syndrome. 131I-human serum albumin (131I-HSA) of 10 microCi loading was intravenously injected to 10 nephrotic (7 minimal change, 3 membranous nephropathy) and 3 non-nephrotic patients. Kinetic study was made by means of two compartment analysis following the 131I-HSA administration. The results were as follows: 1. Albumin synthesis decreased to some extent in nephrotic syndrome. 2. Absolute albumin catabolic rate decreased in nephrotic syndrome. 3. Fractional disappearance rate of albumin (FDR) and albumin turnover rate increased in association with progression of nephrotic syndrome. Both albumin escape into the extravascular pool and urinary excretion rate of albumin also increased. 4. In comparison of two types of nephrotic syndrome, minimal change and membranous nephropathy, it was found that, although renal and peripheral vascular permeabilities increased in both types, minimal change tended to show higher permeability than membranous nephropathy.
肾病综合征中白蛋白代谢异常仍存在争议。为了阐明肾病综合征中白蛋白代谢改变的发病机制,对10例肾病患者(7例微小病变型,3例膜性肾病)和3例非肾病患者静脉注射10微居里负荷的131I-人血清白蛋白(131I-HSA)。在给予131I-HSA后,采用二室分析法进行动力学研究。结果如下:1. 肾病综合征中白蛋白合成有一定程度下降。2. 肾病综合征中白蛋白绝对分解代谢率下降。3. 随着肾病综合征进展,白蛋白分数消失率(FDR)和白蛋白周转率增加。白蛋白逸入血管外池以及白蛋白尿排泄率也增加。4. 比较微小病变型和膜性肾病这两种肾病综合征类型发现,虽然两种类型的肾和外周血管通透性均增加,但微小病变型往往比膜性肾病表现出更高的通透性。