ESWL前后肾内血管阻力和尿中GAL与NAG活性变化的意义

Changes in Intrarenal Vascular Resistance and the Levels of NAG and GAL before and after ESWL

观测体外冲击波碎石(ESWL)治疗50例单侧肾结石病人过程中,肾内血管阻力指数(RI)和尿液中β-D半乳糖苷醇(GAL)与N-乙酰-β-D氨基葡萄糖苷醇(NAG)水平的变化,探讨三者与ESWL所致肾脏损伤及修复过程的关系。结果ESWL后较ESWL前肾内血管RI显著升高(P<0.01);伴尿中NAG水平也明显上升(P<0.05)。而ESWL后1～2周时尿中GAL水平开始升高,且GAL/NAG值呈明显的上升趋势。提示ESWL后所致肾损伤程度与肾内血管RI和尿中NAG水平呈正相关;肾修复时限长短与尿中GAL水平的变化相关,GAL/NAG值的变化可能是肾损伤和修复过程中最有效的临床检测指标。

Intrarenal vascular resistance index (RI) and the levels of N-acetyl-β-D-glucosaminidase (NAG) and β-D-glucosidose in urine were measured in 50 renal lithiasis cases treated by extracorporeal shock wave lithotripsy(ESWL). The results showed that RI in the treated kidneys and NAG in urine significantly increased following ESWL, whereas, RI in the contralateral kidneys has not been different statistically before and following ESWL(P<0. 05). About one or two weeks the GAL levels in urine has been gradually elevated, while there is a tendency that increasing ratios or GAL/NAG was high as ESWL followed. These results suggested that RI,NAG and GAL might serve as effective markers to treat the renovescular damage, and then the ratio of GAL/NAG is more sensitive than simple GAL or NAG as a inditor of the intrarenal injury and recovery after ESWL.