尿酶对糖尿病和高血压的诊断意义。

Enzyme & protein Pub Date : 1994-01-01 DOI:10.1159/000474984
N Ishii, Z Ogawa, H Itoh, H Ikenaga, T Saruta
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引用次数: 20

摘要

为评价糖尿病患者肾小管损伤情况,记录5组患者24小时尿液中肾近端小管衍生酶的活性:(i) 48例肾功能正常、尿白蛋白排泄率在正常范围内的非胰岛素依赖型糖尿病患者;(ii)肾功能正常且尿白蛋白水平高的非胰岛素依赖型糖尿病患者45例;(iii)非胰岛素依赖型糖尿病合并肾功能衰竭患者26例;(iv)原发性高血压且肾功能正常的患者40例,(v)正常对照48例。无论是尿白蛋白排泄率正常或高的非胰岛素依赖型糖尿病患者,还是肾功能不全的糖尿病患者,尿二肽基氨基肽酶IV和n-乙酰- β -d -氨基葡萄糖苷酶的排泄均显著高于健康人,尿γ -谷氨酰转肽酶的排泄均显著低于健康人。原发性高血压患者尿酶排泄无明显变化。这些结果提示,在肾功能正常、尿白蛋白排泄率正常的非胰岛素依赖型糖尿病患者早期存在肾小管损伤。尿中二肽基氨基肽酶IV、n -乙酰- β - d -氨基葡萄糖酶和γ -谷氨酰转肽酶的检测可能对糖尿病肾病的早期诊断特别有用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic significance of urinary enzymes for diabetes mellitus and hypertension.

In order to evaluate tubular damage in diabetic patients, the activity of renal proximal tubule derived enzymes excreted in 24-hour urine were recorded in 5 groups as follows: (i) 48 noninsulin-independent diabetic patients with normal renal function and a urinary albumin excretion rate within the normal range; (ii) 45 noninsulin-dependent diabetic patients with normal renal function and a high urinary albumin level; (iii) 26 noninsulin-dependent diabetic patients with renal failure; (iv) 40 patients with essential hypertension and normal renal function, and (v) 48 normal control subjects. Regardless of whether cases were noninsulin-dependent diabetics with normal or high urinary albumin excretion rate or cases with renal dysfunction, urinary dipeptidyl aminopeptidase IV and N-acetyl-beta-D-glucosaminidase excretions were significantly higher than in healthy subjects, and urinary gamma-glutamyl transpeptidase excretion was significantly lower than in healthy subjects. No significant changes in urinary enzyme excretions showed specific variations in the essential hypertensive patients. These results suggest that there is tubular damage in the early stages of noninsulin-dependent diabetic patients with normal renal function and normal urinary albumin excretion rate. Detection of urinary excretion of dipeptidyl aminopeptidase IV, N-acetyl-beta-D-glucosaminidase and gamma-glutamyl transpeptidase may be especially useful for the early diagnosis of diabetic nephropathy.

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