精氨酸治疗肾小球疾病时肾小管功能损害的临床观察

A Clinic Observation of Treatment of Renal Tubulointerstitial Function Injure in Patients with Glomreul Diseases by L-arginine

目的 :观察精氨酸治疗肾小球疾病时肾小管功能损害的临床效果。方法 :用精氨酸 10 g静滴 ,每天一次 ,治疗有肾小管功能损害的患者 75例 ,其中慢性肾功能不全氮质血症期患者 2 1例。治疗前查血pH值 ,如 pH <7.35 ,予 5 %NaHCO312 5～ 2 5 0ml静滴或口服碳酸氢钠片直至 pH≥ 7.35方用。比较治疗前后尿α1 MG、β2 MG、简化毛氏试验和肾功能。结果 :尿α1 MG治疗前为 43.3± 10 .5mg/L ,治疗后为 16 .3± 6 .6mg/L(P <0 .0 1) ,差异显著 ,尿 β2 MG治疗前 2 2 .7± 9.1mg/L ,治疗后 4.3± 1.4mg/L(P <0 .0 1) ,差异显著。简化莫氏试验结果明显改善 ,慢性肾功能不全患者血Bun治疗前 13 .3± 5 .7mmol/L ,治疗后 8.6± 3 .2mg/L ,血Cr治疗前 2 76± 31μmol/L ,治疗后 177± 2 5 μmol/L ,并异显著 (P <0 .0 1)。结论 :精氨酸可显著改善小管重吸收功能和肾小球滤过功能 ,对于慢性肾功能不全患者而言 ,亦是有效的治疗方法。

Obiective:To obsene the efficacy of L arginine on renal tubulo interstitial injury in patients with glomerul direases.Methods:L arginine was administered to 75 patients including 21 of chronic renal failure.Compared concertrations of α 1 MG and β 2 MG in the urine,modificatory Mosenthal concentration dilution test and renal fuctions between pre and post treatments.Results:α 1 MG were 43.3±10.5 mg/L in pretreatment and 16.3±6.6 mg/L in posttreatment( P &lt;0.01) ;β 2 MG were 22.7±9.1 mg/L in pretreatment and 4.3±1.4 mg/L in posttreatment( P &lt;0.01).Serum Bun in 21 cases with CRF were 13.3±5.7 mmol/L in pretreatment and 8.6±3.2 mg/L in posttreatmen.( P &lt;0.01).Serum Cr were 276±31 mol/L in pretreatment and 177±25 mol/L in postreatment ( P &lt;0.01).Conclusion: L arginine has satisfactory effects in treatment of renal tubuolinterstitial injury in patients with golmerul diseases and chronic renal failure.