尿酶NAG检测在神经源性膀胱功能障碍所致肾脏损伤的意义

Significance of Urinary NAG Enzyme Assay in Renal Impairment Caused by Neurogenic Bladder Dysfunction

目的研究探讨尿酶NAG在神经源性膀胱功能障碍所致肾脏损伤的意义。方法 18只成年雌性wistar大鼠随机分成3组,空白组(不做任何处理)6只,假手术组(只切徐椎板,暴露脊髓硬脊膜)6只,SCI组(切除椎板,暴露脊髓硬脊膜,改良Allen's法造模)6只。取清洁中段尿液检测造模前1d、造模后8h,1d,3d,7d,14d尿液中尿酶NAG、尿微量蛋白(mAld)、肌酐(Cr),收集除造模后8h外所有时点24h尿液,检测24h总蛋白(mTP)的含量变化,为消除尿量及尿流率对个别数据结果的影响,所有结果均以NAG/Cr,mAlb/Cr,mTP/Cr来表示。结果 SCI组术后8h NAG/Cr即开始较SCI术前1d显著升高(P<0.05);SCI组术后1d mAlb/Cr即开始较术前1d显著升高(P<0.05);SCI组术后3d开始较术前1d显著升高(P<0.05);SCI组术后14dNAG/Cr与术前1d无显著差异(P>0.05)。结论尿酶NAG活性水平变化敏感于尿微量蛋白(mAld)和24h总蛋白(mTP)的变化,可作为判断神经源性膀胱障碍患者早期肾功能损伤及修复的监测指标。

[ ABSTRACT] Objective To study significance of urinary NAG enzyme assay in renal impairment caused by neurogenic bladder dysfunction.Methods Eighteen female adult Wistar rats were randomly divided into 3 groups,Blank Group（without any treatment） 6,Sham Operation Group（Resection Lamina only,Exposure Spinal dural）6,SCI Group（Resection Lamina,Exposure Spinal dural,Manufacturing mod-el with Allen ＇s method） 6.Middle urine were collected to test NAG ,mAlb,Cr at 1d before SCI and postoperative 8hour,1d,3d,7d,14d. Tweenty-four hours urine of all the time points（except postoperative 8hour）were collected to test the total protein content .In order to elimi-nate the influence of urine volume and urinary flow rate on individual data results ,all the results were represented by NAG/Cr,mAlb/Cr and mTP/Cr.Results NAG/Cr of group SCI at postoperative 8h starts to increase significantly than 1d before operation,there was statistical sig-nificance（P〈0.05）;mAlb/Cr of group SCI at postoperative 1d starts to increase significantly than 1d before operation,there was statistical significance（P〈0.05）;mTP/Cr of group SCI at postoperative 3d starts to increase significantly than 1d before operation,there was statistical significance（P〈0.05）;NAG/Cr of group SCI at postoperative 14d had no significant difference with 1d before operation（P〉0.05）.Con-clusion Changes in the levels of activity of urinary enzyme NAG is more sensitive than the urine trace protein （mAlb） and total 24h protein （ mTP）;it can be used as a monitoring index to judge the injury and repairment of early renal function in patients with neurogenic bladder disorder.