PREDICTIVE VALUE OF URINARY N-ACETYL-BETA-D-GLUCOSAMINIDASE (NAG), ALANINE-AMINOPEPTIDASE (AAP) AND BETA-2-MICROGLOBULIN (BETA-2M) IN EVALUATING NEPHROTOXICITY OF GENTAMICIN
PREDICTIVE VALUE OF URINARY N-ACETYL-BETA-D-GLUCOSAMINIDASE (NAG), ALANINE-AMINOPEPTIDASE (AAP) AND BETA-2-MICROGLOBULIN (BETA-2M) IN EVALUATING NEPHROTOXICITY OF GENTAMICIN
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DOI：
10.1016/0009-8981(81)90165-0
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发表时间：
1981-01-01
影响因子：
5
通讯作者：
HENRY, JC
中科院分区：
文献类型：
--
作者：
GIBEY, R;DUPOND, JL;HENRY, JC
每天测定28名用庆大霉素（每天2-3mg/kg）治疗的患者的尿液中N-乙酰基-β-D-氨基葡萄糖苷酶（NAG）、丙氨酸氨基肽酶（AAP）和β2-微球蛋白（β2M）的浓度，平均持续15天。所有患者的肾功能均正常。所有患者在治疗后立即或治疗 2 或 3 天后观察到 NAG 和 AAP 活性增加。将结果与血清肌酐浓度和尿β2M水平进行比较。庆大霉素的肾毒性与任何治疗前的初始尿酶活性（NAGi）之间存在关系。治疗前 10 天的 NAG 反应程度是第二个预后因素。 12 名 NAGi 正常（NAGi < 200 μmol/天）的患者中，有 1 名观察到肾衰竭；图7显示了显着的酶活性响应(>1500μmol/天)，其中β2M活性增加； 16 名 NAGi 升高（NAGi > 200 μmol/天）的患者中有 11 名出现肾功能衰竭，并表现出最大反应升高。 AAP 浓度的预后价值不大。治疗前 10 天，28 名患者中观察到的个体最大尿酶反应存在差异，表明个体对庆大霉素存在敏感性，但其确切机制尚不清楚。
Concentrations of N-acetyl-.beta.-D-glucosaminidase (NAG), alanine aminopeptidase (AAP) and .beta.2-microglobulin (.beta.2M) were determined daily in the urine of 28 patients treated with gentamicin (2-3 mg/kg per day) for a mean of 15 days. All had normal renal function. Increased activity in NAG and AAP was observed for all patients immediately or after 2 or 3 days of treatment. Results were compared with serum creatinine concentrations and urinary .beta.2M levels. A relationship between the nephrotoxicity of gentamicin and initial urinary enzymic activity (NAGi) prior to any treatment was seen. The degree of NAG response during the first 10 days of treatment appeared as a 2nd prognostic factor. Renal failure was observed for 1 of 12 patients with normal NAGi (NAGi < 200 .mu.mol/day); 7 showed a marked enzyme activity response (> 1500 .mu.mol/day) with an increase in .beta.2M activity; and 11 of 16 patients with elevated NAGi (NAGi > 200 .mu.mol/day) developed renal failure and showed an elevated maximal response. The concentration of AAP was of little prognostic value. The variation in individual maximal urinary enzyme responses observed among the 28 patients during the first 10 days of treatment pointed to the existence of individual sensitivities to gentamicin, the exact mechanism of which remains unclear.