Yanagisawa T, Yamada A, Kurooka Y, Nishimori S, Kuzuhara K, Ogura Y, Otsubo O
Kidney Center, Toranomon Hospital, Tokyo, Japan.
Nihon Jinzo Gakkai Shi. 1993 Sep;35(9):1059-63.
Urinary excretion of albumin was measured after renal transplantation in 37 patients who received cyclosporine quadrotherapy (cyclosporine A, azathioprine, prednisolone and antilymphocytoglobulin). In 26 patients with a favorable clinical course, daily urinary albumin level increased significantly on the first operative day. Subsequently, it decreased gradually, and remained at about 40mg/day after 3 weeks. In these patients, the urinary albumin level did not correlate with blood pressure, whole blood cyclosporine level, serum creatinine level nor urinary enzyme level, i.e. beta 2-microglobulin, NAG, gamma-GTP. As for correlation between the urinary albumin level and biopsy findings in 21 patients who underwent renal graft biopsy, the urinary albumin level was significantly increased in 5 patients with high degree of lymphocyte infiltration in the renal graft as compared with 16 patients with low degree of infiltration. However, there was no significant correlation between the urinary albumin level and the degree of tubular damage. In 4 patients of allograft rejection, a clinical course was reflected better in the albumin level than in the urinary enzyme level, these results show that the measurement of urinary albumin is a useful clinical examination to evaluate the allograft rejection of renal transplantation in cyclosporine era.
对37例接受环孢素四联疗法（环孢素A、硫唑嘌呤、泼尼松龙和抗淋巴细胞球蛋白）的肾移植患者术后的尿白蛋白排泄情况进行了测定。在26例临床病程良好的患者中，术后第一天尿白蛋白水平显著升高。随后逐渐下降，3周后维持在约40mg/天。在这些患者中，尿白蛋白水平与血压、全血环孢素水平、血清肌酐水平以及尿酶水平（即β2-微球蛋白、NAG、γ-GTP）均无相关性。对于21例行肾移植活检患者的尿白蛋白水平与活检结果之间的相关性，与16例浸润程度低的患者相比，5例肾移植中淋巴细胞浸润程度高的患者尿白蛋白水平显著升高。然而，尿白蛋白水平与肾小管损伤程度之间无显著相关性。在4例发生移植肾排斥反应的患者中，白蛋白水平比尿酶水平能更好地反映临床病程，这些结果表明，尿白蛋白测定是环孢素时代评估肾移植同种异体排斥反应的一项有用的临床检查。
