Donadio C, Tramonti G, Lucchesi A, Giordani R, Lucchetti A, Bianchi C
Unità di Nefrologia, University of Pisa, Italy.
Ren Fail. 1998 Mar;20(2):319-24. doi: 10.3109/08860229809045117.
The aim of this study was to evaluate the usefulness of the measurement of urinary excretion of the brush-border enzyme gamma glutamyl-transferase (GGT), in comparison with that of alanine aminopeptidase (AAP), as a marker for tubular toxicity due to contrast media (CM). Urinary activities of AAP and GGT were measured prior to the administration of CM and 1, 3 and 5 days after in forty-nine adult renal patients undergoing a radiological examination with intravascular administration of CM. The behavior of GGT was similar to that of AAP. In fact, urinary activities of both AAP and GGT increased greatly after CM. This effect was maximal on the 1st day and statistically significant for both enzymes. Furthermore, on the 1st day a relevant increase of enzyme activity (at least +50% over the basal value) was observed in the same number of patients (67%) for AAP and GGT. The concordance between GGT and AAP variations was high and statistically significant. Finally, different variables (osmolarity, dose of CM, and baseline renal function of the patients) had a similar effect on urinary excretion of AAP and GGT. The repeatability of duplicated determinations of GGT resulted better than that of AAP. In conclusion, the good concordance of the results of GGT with those of AAP justifies the use of GGT as a marker for tubular effects due to CM. Furthermore, the measurement of GGT has a better repeatability than that of AAP.
本研究的目的是评估与丙氨酸氨基肽酶（AAP）相比，测量尿中刷状缘酶γ-谷氨酰转移酶（GGT）作为造影剂（CM）所致肾小管毒性标志物的实用性。在49例接受血管内注射CM进行放射学检查的成年肾病患者中，于注射CM前及注射后1、3和5天测量尿中AAP和GGT的活性。GGT的变化情况与AAP相似。事实上，CM注射后AAP和GGT的尿活性均大幅增加。这种效应在第1天最为明显，且两种酶的变化均具有统计学意义。此外，在第1天，AAP和GGT在相同数量（67%）的患者中观察到酶活性有显著升高（至少比基础值增加50%）。GGT和AAP变化之间的一致性很高且具有统计学意义。最后，不同变量（渗透压、CM剂量和患者的基线肾功能）对AAP和GGT的尿排泄有相似影响。GGT重复测定的重复性优于AAP。总之，GGT与AAP结果的良好一致性证明了GGT可作为CM所致肾小管效应的标志物。此外，GGT的测量比AAP具有更好的重复性。
