尿酶检测早期诊断庆大霉素肾脏损害的动物实验与临床研究

EXPERIMENTAL AND CLINICAL STUDIES ON EARLY DIAGNOSIS OF NEPHROTO-XICITY OF GENTAMICIN BY THE DETERMINATION OF URINE ENZYMES

采用犬庆大霉素肾中毒模型,结合临床病例,检测尿丙氨酸氨基肽酶、N-乙酰—β—氨基葡萄糖苷酶、γ-谷氨酰转肽酶、乳酸脱氢酶的变化和犬肾超微结构改变。结果显示,治疗剂量庆大霉素对肾脏具有损害作用,中毒量的损害明显加重;处于亚临床期肾病变者,庆大霉素显著加重其毒性损害。检测尿酶的变化可以早期反映出这种肾毒性损害,是一种灵敏的早期监测指标。

The value of determination of urine enzymes in the early diagnosis of nephrotoxicity of gentamic-in (GM) was evaluated. Concentration of alanine aminopeptidase (AAP), N-acetyl-bcta-glucosamini-dase (NAG), y-glutamyltranferase (GGT) and lactate dehydrogenase (LDH) were determined in the urine of 66 patients who were receiving GM (160-240 mg/d) for 6 to 8 days, and 12 dogs receiving 5 mg/d of GM for 10 dars and 12 dogs receiving 40 mg/d of GM for 7 days. The results were compared with the levels of serum creatinine and histopathology of the kidney.It was found that even the therapeutic dosage of GM might give rise to damage of the kidney. A close correlation was found between the damage of the kidney as shown on pathological examination and the output of enzymes in urine. The rise of enzymes in urine might be taken as an early sign of renal damage. Urinary AAP, NAG, GGT, LDH may be used as monitors for nephrotoxicity of GM.