Maesaka J K, Wolf-Klein G, Piccione J M, Ma C M
Division of Nephrology, Long Island Jewish Medical Center, New Hyde Park, NY 11042.
J Am Geriatr Soc. 1993 May;41(5):501-6. doi: 10.1111/j.1532-5415.1993.tb01885.x.
To study tubular urate transport in Alzheimer's disease (AD) and measure sodium and lithium transport rates in rats exposed to AD plasma.
Cross-sectional study in three comparison groups.
Referral private institution involving outpatient and hospitalized patients.
AD, multi-infarct dementia (MID) and non-demented controls (C) were selected and evaluated by a geriatrician and a psychiatrist according to availability and willingness to participate in the study. Demented patients had brain imaging, categorized according to NINCDS-DSM III criteria, and had Mini-mental status examination (MMSE) scores determined.
Injection of 0.5 mL of plasma I.P. followed 120 minutes later by an IV plasma injection of 0.2 mL priming dose and infusion of 1.8 mL of plasma at 0.01 mL/min in Sprague Dawley rats.
Renal clearance studies were performed in subjects and in rats exposed to the plasma of study subjects. We measured serum urate concentration and fractional excretion (FE) of urate in subjects and FE sodium and FE lithium in rats.
Serum urate was lower and FE urate higher in 18 AD patients compared with six patients with MID, P < 0.05 and P < 0.005, and 11 C, P < 0.02 and P < 0.005, respectively. Higher FE sodium and FE lithium were noted in rats given plasma from 19 AD patients compared with 12 with MID, P < 0.005 and P < 0.0025, and 14 C, P < 0.0025 and P < 0.0005, respectively. FE sodium and FE lithium decreased progressively after serial dilutions of three AD plasmas and FE lithium was negatively correlated with MMSE scores only in AD, r = -0.71 and P < 0.0005.
In AD there is defective tubular urate transport and a plasma natriuretic factor(s). FE sodium and/or FE lithium in rats exposed to plasma of demented patients may differentiate AD from MID and estimate the severity of AD.
研究阿尔茨海默病（AD）中肾小管尿酸转运情况，并测量暴露于AD患者血浆的大鼠的钠和锂转运速率。
在三个比较组中进行横断面研究。
涉及门诊和住院患者的转诊私立机构。
根据可及性和参与研究的意愿，选择AD患者、多发梗死性痴呆（MID）患者和非痴呆对照组（C），并由一名老年病学家和一名精神科医生进行评估。痴呆患者进行脑成像检查，根据NINCDS - DSM III标准进行分类，并测定简易精神状态检查（MMSE）评分。
给斯普拉格 - 道利大鼠腹腔注射0.5 mL血浆，120分钟后静脉注射0.2 mL起始剂量的血浆，并以0.01 mL/分钟的速度输注1.8 mL血浆。
在研究对象以及暴露于研究对象血浆的大鼠中进行肾脏清除率研究。我们测量了研究对象的血清尿酸浓度和尿酸排泄分数（FE），以及大鼠的FE钠和FE锂。
18例AD患者的血清尿酸水平低于6例MID患者，P < 0.05和P < 0.005，低于11例对照组，P < 0.02和P < 0.005；AD患者的FE尿酸高于MID患者和对照组。与12例MID患者相比，给予19例AD患者血浆的大鼠中FE钠和FE锂更高，P < 0.005和P < 0.0025；与14例对照组相比，P < 0.0025和P < 0.0005。三种AD血浆连续稀释后，FE钠和FE锂逐渐降低，且仅在AD组中FE锂与MMSE评分呈负相关，r = -0.71，P < 于0.0005。
在AD中存在肾小管尿酸转运缺陷和一种血浆利钠因子。暴露于痴呆患者血浆的大鼠的FE钠和/或FE锂可能有助于区分AD与MID，并评估AD的严重程度。
