Tataranni G, Farinelli R, Zavagli G, Logallo G, Farinelli A
J Urol. 1987 Jul;138(1):24-7. doi: 10.1016/s0022-5347(17)42975-2.
The recovery of tubules after relief of obstructive nephropathy may be investigated through serial assessment of the urinary excretion of tubular enzymes alpha-glucosidase, gamma-glutamyl-transferase and N-acetyl glucosaminidase as well as of the microprotein beta-2-microglobulin. We studied 21 patients in whom obstructive nephropathy was relieved by operative or nonoperative methods. Anuria persisted from 2 to 14 days. In these patients urinary excretion of alpha-glucosidase, gamma-glutamyl-transferase, N-acetyl glucosaminidase and beta-2-microglobulin, as well as the serum creatinine were assessed weekly. Serum creatinine was the earliest index to return to normal (within 9 to 26 days). Enzymuria returned to normal within 35 to 45 days, whereas normal urinary excretion of beta-2-microglobulin occurred more than 100 days after relief of obstructive nephropathy. N-acetyl glucosaminidase and gamma-glutamyl-transferase proved to be more reliable than alpha-glucosidase in detecting recovery of the luminal membrane of the proximal tubule. The return to normal of urinary beta-2-microglobulin levels has been shown to occur later, since more specific and complex intracellular functions underlie this index. The pathophysiological aspects of recovery of obstructive nephropathy may be considered similar to those observed in ischemic acute renal failure, since in both instances hemodynamic changes are involved.
通过对肾小管酶α-葡萄糖苷酶、γ-谷氨酰转移酶和N-乙酰葡糖胺酶以及微蛋白β2-微球蛋白的尿排泄情况进行系列评估，可研究梗阻性肾病解除后肾小管的恢复情况。我们研究了21例通过手术或非手术方法解除梗阻性肾病的患者。无尿持续2至14天。对这些患者每周评估α-葡萄糖苷酶、γ-谷氨酰转移酶、N-乙酰葡糖胺酶和β2-微球蛋白的尿排泄情况以及血清肌酐水平。血清肌酐是最早恢复正常的指标（在9至26天内）。酶尿在35至45天内恢复正常，而β2-微球蛋白的尿排泄在梗阻性肾病解除100多天后才恢复正常。在检测近端小管管腔膜的恢复方面，N-乙酰葡糖胺酶和γ-谷氨酰转移酶比α-葡萄糖苷酶更可靠。尿β2-微球蛋白水平恢复正常较晚，因为该指标涉及更特异和复杂的细胞内功能。梗阻性肾病恢复的病理生理学方面可能与缺血性急性肾衰竭中观察到的情况相似，因为在这两种情况下都涉及血流动力学变化。
