Hanbeyoğlu Alpaslan, Kazez Ahmet, Ustündağ Bilal, Akpolat Nusret
Department of Pediatric Surgery, Fırat University Faculty of Medicine, Elazığ, Turkey.
Ulus Travma Acil Cerrahi Derg. 2011 Nov;17(6):475-81. doi: 10.5505/tjtes.2011.57973.
We evaluated the applicability of urinary N-acetyl-beta-D glucosaminidase (NAG) levels in the diagnosis and follow-up in blunt kidney injury.
Twenty Sprague-Dawley rats were studied. In the Sham group, left kidney exploration was made. In the Trauma group, after left kidney exploration, a 20 g weight was dropped onto the kidneys. Urine was collected for analysis with strip and determination of urinary NAG and creatinine (Cr) levels at baseline and 0-6, 12-24, 24-36 and 36-48 postoperative hours. Mann-Whitney U and Kruskal-Wallis tests were used.
Macroscopic examinations of traumatized kidneys revealed grade II and III injury, and histopathological examinations showed relevant changes. Macroscopic hematuria was observed in all traumatized rats. Urinary NAG/Cr levels in the Trauma group were found to be significantly higher than their base levels at 0-6, 12-24, 24-36, and 36-48 hours. In the Sham group, only the level of NAG/Cr at 0-6 hours was significantly higher. The increase in NAG/Cr levels at 0-6 hours was significantly higher in the Trauma group than in the Sham group.
After isolated blunt renal trauma, urinary NAG levels increase in the early stage. However, more detailed clinical studies are needed to develop NAG levels as a criterion in the follow-up of blunt renal trauma.
我们评估了尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)水平在钝性肾损伤诊断及随访中的适用性。
对20只Sprague-Dawley大鼠进行研究。假手术组进行左肾探查。创伤组在左肾探查后,将一个20克的重物坠落到肾脏上。收集尿液,用试纸条分析,并在基线以及术后0 - 6、12 - 24、24 - 36和36 - 48小时测定尿NAG和肌酐(Cr)水平。采用Mann-Whitney U检验和Kruskal-Wallis检验。
对受创伤肾脏的宏观检查显示为Ⅱ级和Ⅲ级损伤,组织病理学检查显示有相关变化。所有受创伤大鼠均观察到肉眼血尿。创伤组在术后0 - 6、12 - 24、24 - 36和36 - 48小时的尿NAG/Cr水平显著高于其基线水平。在假手术组,仅0 - 6小时的NAG/Cr水平显著升高。创伤组0 - 6小时NAG/Cr水平的升高显著高于假手术组。
孤立性钝性肾创伤后,尿NAG水平在早期升高。然而,需要更详细的临床研究来将NAG水平作为钝性肾创伤随访的一项标准。