Yajima I, Nishimura T, Yoshida K, Tomita M, Hikima N, Kawamura N, Tsuboi N, Honda R, Akimoto M
Department of Urology, Nippon Medical University.
Hinyokika Kiyo. 1987 May;33(5):662-8.
To examine the influence of percutaneous nephrolithotomy (PNL) on renal function, we measured the activity of urinary N-acetyl-beta-D-glucosaminidase (NAG) and beta 2-microglobulin (beta 2MG) in patients with nephrolithiasis, before and 3, 5, 7, 14 days and 1 month after PNL. With PNL, renal function was recovered within one month, and PNL was thought to be a more protective method than pyelolithotomy. Recovery of renal function was delayed in the cases in which PNL had been attempted over three times. In the patients with preoperative high-grade hydronephrosis, the excretion of NAG and beta 2MG in the urine was delayed. NAG-index was considered to be a more sensitive parameter than beta 2MG to evaluate renal function. The NAG-index and beta 2MG values of bladder urine were in good correlation with those of nephrostomy urine 5 days or more postoperatively. Measurement of the urinary NAG-index 3, 7, 14, 30 days after PNL operation was considered valuable for determining changes in renal function.
为研究经皮肾镜取石术(PNL)对肾功能的影响,我们测定了肾结石患者在PNL术前、术后3天、5天、7天、14天及1个月时尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)和β2-微球蛋白(β2MG)的活性。采用PNL时,肾功能在1个月内恢复,且PNL被认为是比肾盂切开取石术更具保护性的方法。在尝试PNL超过3次的病例中,肾功能恢复延迟。术前存在重度肾积水的患者,尿中NAG和β2MG的排泄延迟。NAG指数被认为是比β2MG更敏感的评估肾功能的参数。术后5天及以上,膀胱尿的NAG指数和β2MG值与肾造瘘尿的这些值具有良好的相关性。在PNL术后3天、7天、14天、30天测定尿NAG指数对确定肾功能变化具有重要价值。