Wiesmann U, Peheim E, Colombo J P
Medizinische Kinderklinik, Inselspital, Universität Bern.
Klin Wochenschr. 1989;67 Suppl 17:40-3.
N-acetyl-beta-D-glucosaminidase activity, alpha 1-microglobulin, albumin, and creatinine were determined in urine specimens of healthy children, age 4 months up to 15 years, and of children with type I diabetes and of juvenile patients receiving amikacin, an aminoglycoside antibiotic, during severe systemic infections. All resulting values were expressed per g of creatinine. beta-Glucosaminidase activity was determined colorimetrically using 3-cresolsulfonphthaleinyl-N-acetyl-beta-D-glucosaminide as a substrate. Creatinine was determined by a modified Jaffé reaction. alpha 1-microglobulin and albumin were measured by immunodiffusion. In normal urine beta-glucosaminidase activity showed a log-normal distribution with an upper limit 97.5 percentile of 3.61 U/g creatinine. In patients receiving amikacin for up to 3 weeks beta-glucosaminidase and alpha 1-microglobulin significantly rose to very high values (6-10 times) during the course of the treatment. Urinary albumin values was only doubled. All values returned to normal, days or occasionally weeks after discontinuation of the therapy. 3 groups of diabetic children could be distinguished using urinary beta-glucosaminidase as a discriminator a) children with repeatedly normal activities, b) children with intermittently elevated activities and c) children with repeatedly elevated activities. While alpha 1-microglobulin concentrations followed the same pattern, the excretion of albumin did not.(ABSTRACT TRUNCATED AT 250 WORDS)
在4个月至15岁健康儿童、1型糖尿病儿童以及在严重全身感染期间接受氨基糖苷类抗生素阿米卡星治疗的青少年患者的尿液样本中,测定了N - 乙酰 - β - D - 氨基葡萄糖苷酶活性、α1 - 微球蛋白、白蛋白和肌酐。所有结果值均以每克肌酐表示。β - 氨基葡萄糖苷酶活性采用3 - 甲酚磺酞基 - N - 乙酰 - β - D - 氨基葡萄糖苷作为底物通过比色法测定。肌酐通过改良的Jaffe反应测定。α1 - 微球蛋白和白蛋白通过免疫扩散法测量。在正常尿液中,β - 氨基葡萄糖苷酶活性呈对数正态分布,肌酐水平97.5百分位数的上限为3.61 U/g。在接受阿米卡星治疗长达3周的患者中,β - 氨基葡萄糖苷酶和α1 - 微球蛋白在治疗过程中显著升高至非常高的值(6 - 10倍)。尿白蛋白值仅翻倍。治疗停止数天或偶尔数周后,所有值均恢复正常。使用尿β - 氨基葡萄糖苷酶作为鉴别指标,可以区分3组糖尿病儿童:a)活性反复正常的儿童;b)活性间歇性升高的儿童;c)活性反复升高的儿童。虽然α1 - 微球蛋白浓度遵循相同模式,但白蛋白排泄情况并非如此。(摘要截短至250字)