Kanauchi M, Ishii K, Nishiura K, Dohi K
First Department of Internal Medicine, Nara Medical University, Japan.
Nihon Jinzo Gakkai Shi. 1994 Aug;36(8):928-33.
We investigated the effects of exercise on hemodynamics and urinary protein excretion in 15 patients with early-stage diabetic nephropathy (DN) as compared the findings with these of 16 healthy volunteers. Patients were divided into two groups according to their renal histopathologic findings; Group D0 consisted of 8 patients in whom light microscopy showed minor glomerular abnormalities and Group DI consisted of 7 patients with early stage diffuse lesions. The subjects exercised on a treadmill at a workload of 4.7 METS for 20 minutes. Systolic blood pressure, heart rate and the pressure rate product were significantly higher in the DI group than in the D0 and control groups during exercise. Diastolic blood pressure was similar among the three groups. Creatinine clearance was unchanged during exercise. Urinary albumin excretion, urinary acid soluble protein excretion and urinary alpha 1-microglobulin excretion were all significantly increased in group DI compared with the D0 and control groups. Excretion of beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase activity were unchanged during exercise. Our findings suggest that this provocative exercise test is useful for diagnosing early-stage diabetic nephropathy.
我们研究了运动对15例早期糖尿病肾病（DN）患者血流动力学及尿蛋白排泄的影响，并将结果与16名健康志愿者进行比较。根据肾脏组织病理学检查结果将患者分为两组；D0组由8例光镜显示肾小球轻度异常的患者组成，D1组由7例早期弥漫性病变患者组成。受试者在跑步机上以4.7梅脱的负荷运动20分钟。运动期间，D1组的收缩压、心率及压力心率乘积显著高于D0组和对照组。三组间舒张压相似。运动期间肌酐清除率无变化。与D0组和对照组相比，D1组的尿白蛋白排泄、尿酸溶性蛋白排泄及尿α1-微球蛋白排泄均显著增加。运动期间β2-微球蛋白排泄及N-乙酰-β-D-氨基葡萄糖苷酶活性无变化。我们的研究结果表明，这种激发运动试验有助于早期糖尿病肾病的诊断。
