The serum level and urinary excretion of beta2-microglobulin in health and renal disease.
The serum level and urinary excretion of beta2-microglobulin in health and renal disease.
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健康和肾脏疾病中β2-微球蛋白的血清水平和尿液排泄。
DOI：
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发表时间：
1978
期刊：
影响因子：
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通讯作者：
L. Wibell
中科院分区：
文献类型：
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作者：
L. Wibell
在肾功能正常的健康受试者中，β -微球蛋白（β - 2m）在体内不断产生。它几乎完全由肾脏排出，主要通过肾小球滤过，但也可能直接从血液中摄取。在肾小球滤过后，超过99.9%的排泄蛋白在肾小管中被再吸收并分解代谢。影响血清β - 2水平的主要因素是GFR。s - β - 2m的测定似乎比s -肌酐的分析更有效地检测略有降低的GFR。与GFR相比，较高的s - β 2可见于恶性增生性疾病和SLE。这表明蛋白质的产量增加了。在健康受试者中，β - 2m不太可能完全自由地通过肾小球膜，但在肾病患者中，其筛选系数可能接近1。这种蛋白在肾小球中消除的增加可能会被合成的增加所抵消，这就解释了s - β - 2m和GFR之间在对数/对数尺度上的显著关系。在许多临床情况下，尿中β - 2的排泄量增加是近端肾小管功能障碍的敏感指标。然而，在明显的肾功能不全中，正常排泄量必然增加100- 1000倍，这与肾脏疾病的种类无关。在蛋白质的研究中，预防措施是必要的，以避免蛋白质降解，在尿与低pH值。
In healthy subjects with normal renal function beta2-microglobulin (beta2m) is constantly produced in the body. It is eliminated almost exclusively by the kidneys, predominantly by glomerular filtration but possibly also by some direct uptake from the blood. After glomerular filtration more than 99,9% of excreted protein is reabsorbed in the kidney tubules where it is catabolized. The main factor, influencing on the serum level of beta2m is the GFR. Determination of S-beta2m appears to be more effective than analysis of S-creatinine for the detection of a slightly reduced GFR. A relatively high S-beta2m, in comparison with the GFR, may be seen in e.g. malignant proliferative disorders and SLE. This indicates an increased production of the protein. An entirely free passage over the glomerular membranes is not likely for beta2m in healthy subjects but the sieving coefficient might approach 1,0 in renal disease. The increased glomerular elimination of the protein could then possibly be counterbalanced by an increased synthesis, which should explain the pronounced relationship at a log/log scale between S-beta2m and the GFR. An increased excretion of beta2m in the urine is a sensitive indicator of proximal tubular dysfunction in many clinical conditions. In marked renal insufficiency there is, however, an obligatory 100-1 000-fold increase of the normal excretion, not related to the kind of renal disorder. In studies of the protein precautions are necessary to avoid degradation of the protein, in urine with a low pH.