尿系列微量蛋白测定在抗菌药物早期肾损害监测中的作用

Clinical Implication of Serial Microproteinuria in the Detection of Early Renal Damage by Antibiotics

为探讨抗菌药物致肾脏损害早期监测的方法,对使用无肾毒性(头孢三嗪)、轻度肾毒性(头孢唑啉)、明显肾毒性(庆大霉素)三种不同药物的患者用药前及用药后1周测定其血尿素氮、肌酐、尿β_2-微球蛋白、尿视黄醇结合蛋白、尿微量白蛋白、尿IgG、尿N-乙酰-β-氨基葡萄糖苷酶.结果发现头孢三嗪患者用药前后各项指标均无明显改变;头孢唑啉组者尿系列微量蛋白显著增高时(P<0.01或P<0.05),血尿素氮、肌酐仍无明显改变(P>0,05);庆大霉素组血肌酐轻度上升时,而尿系列微量蛋白成倍增高.提出尿系列微量蛋白的测定对药物肾毒性的早期监测具有一定的临床意义.

In order to find a method to detect the early damage due to use of antibiotics, we examined the serum BUN, Cr and urinary 2-MG, Alb, NAG of patients one week before and after use of antibiotics. The patients were divided into 3 groups: ceftriaxon group, cephazolin group and gentamycin group. The results showed that none of the parameters changed in ceftriaxon group; urinary serial microprotein increased markedly but serum BUN, Cr reveal no change in cephazolin group and serum Cr rose Mildly and urinary serial microprotein increased by several times in gentamyin group. Our findings suggested that detection of serial microproteinuria is helpful in the diagnosis of early renal damage by drugs.