尿N-乙酰-β-D-氨基葡萄糖苷酶对监测早期肾功能损害的价值

Clinical value of urinary NAG activity for the estimation of early renal damage

目的探讨尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)监测早期肾功能损坏的价值。方法根据内生肌酐清除率(Ccr)将120例肾病患者分为A、B两组,A组58例,其Ccr≥80 mL/min。B组62例,其Ccr<80 mL/min。分别检查A、B两组和50例健康人的尿NAG(U/mmol Cr),并与其尿微量清蛋白〔mAlb(mg/mmol Cr)〕和血肌酐(Cr)含量进行比较。结果A、B两组肾病患者尿NAG、mAlb检测结果显著高于健康对照组,差异有统计学意义(P<0.05),B组患者尿NAG、mAlb检测结果显著高于A组,差异有统计学意义(P<0.05);在A、B两组中,尿NAG的阳性率显著高于尿mAlb和血Cr,差异也有统计学意义(P<0.05);肾病患者尿NAG活性与Ccr具有良好的相关性,差异有统计学意义(r=0.876,P<0.05)。结论尿NAG在肾病早期有较高的检出率,可作为监测早期肾功能损害的敏感指标。

Objective To investigate the clinical value of N-acetyl-beta-D-glucosaminidase（ NAG ） for estimation of early renal damage. Methods 120 nephropathy patients were divided into two groups according to their creatinine clearance （Ccr）. Group A was made up of 58 patients,whose Ccr Ccr≥80 mL/min,and 62 patients in group B with a Ccr（80 mL/min. The urinary activities of NAG（ U/mmol Cr） was measured in 50 healthy subjects and all nephropathy patients. The results were compared with urinary microalbuminuria [mAlb（ U/mmol Cr）] and serum creatinine（Cr）. Results In the nephropathy patients, the NAG activities and mAlb levels were increased in both groups compared with the healthy control（P〈0.05）. The levels of NAG and mAlb were elevated in group B（P〈0.05）, compared to group .＆. The positive rate of NAG was higher than that of mAlb and Cr（P〈0.05）in groups A and B. There was a significantly positive relationship between Ccr and NAG（r=0. 876,P〈0.05）. Conclusion There was high testing rate of urine NAG in early renal impairment, which could be regarded as a sensitive marker for early diagnosis of nephropathy.