Terashima S
First Department of Surgery, Fukushima Medical School, Japan.
Nihon Geka Gakkai Zasshi. 1989 Jul;90(7):999-1008.
It is well known that acute renal failure (ARF) after surgery has a high mortality rate. The purpose of this paper is to clarify the renal tubular damage following surgery. Urinary beta 2 microglobulin (u-BMG) and urinary N-acetyl-beta-D-glucosaminidase (u-NAG) activities, thought to be the sensitive indicators of renal tubular impairment, were measured in 48 patients treated surgically in our clinic. Three out of 48 patients developed ARF. Remaining 45 showed normal values in conventional renal function tests, while u-BMG and u-NAG revealed abnormally high levels in many cases. Bleeding amount during surgery, operative time, postoperative complications, especially circulatory shock, and preoperative hypotention were the factors which correlated closely to the elevation of u-BMG and u-NAG. Administration of urinastatin prevented the u-NAG elevation postoperatively, while it had no effect on u-BMG.
众所周知，术后急性肾衰竭（ARF）的死亡率很高。本文的目的是阐明手术后的肾小管损伤情况。我们对本诊所接受手术治疗的48例患者测定了尿β2微球蛋白（u-BMG）和尿N-乙酰-β-D-氨基葡萄糖苷酶（u-NAG）活性，这两种指标被认为是肾小管损伤的敏感指标。48例患者中有3例发生了ARF。其余45例患者的常规肾功能检查结果正常，但在许多病例中u-BMG和u-NAG显示出异常高水平。手术中的出血量、手术时间、术后并发症，尤其是循环休克以及术前低血压是与u-BMG和u-NAG升高密切相关的因素。乌司他丁的使用可防止术后u-NAG升高，但对u-BMG没有影响。
