高原红细胞增多症患者尿白蛋白和N-乙酰-β-D-氨基葡糖苷酶的排泄变化  

Excretive Changes of Urinary Albumin and N-Cety-Beta-Glucosaminidase in High Altitude Polycythemia at High Altitudes and Its Mechanism

作　　者：郗焜[1] 常荣[2] 阿祥仁[2] 周晶萍[2] 刘兰[2] 

机构地区：[1]苏州大学医学部,09级5班215123 [2]青海省人民医院,810007

出　　处：《青海医药杂志》2012年第11期1-3,共3页Qinghai Medical Journal

摘　　要：目的:对海拔高度3 300m(刚察县)高原红细胞增多症(HAPC)患者尿白蛋白(ALB)和N-乙酰-β-D-氨基葡糖苷酶(NAG)的排泄变化进行了观察并探讨了可能的机制变化。方法:对海拔高度3 300m HAPC患者38例和健康人115例分别采用尿蛋白酶标免疫法、邻苯三酚自氧化法、TBA和酶法检测了尿ALB、NAG、红细胞滤过指数(EFl)、红细胞超氧化物歧化酶(SOD)活性和血浆丙二醛(MDA)含量。结果:HAPC患者尿ALB、NAG、血浆MDA含量和EFI明显高于同海拔健康组,而红细胞SOD活性明显低于同海拔健康组;相关和多因素逐步回归分析表明,尿ALB和NAG与EFI呈正相关,而与血浆MDA含量、红细胞SOD、血红蛋白、红细胞、红细胞压积水平无明显相关。结论:红细胞变形能力(ED)对尿ALB和NAG存在独立影响,HAPC患者机体脂质过氧化反应增强,可能导致ED降低,造成肾内微循环障碍,可能是尿ALB和NAG含量产生增多的病理生理机制之一。To study the changes of excretive amount of Albumin(ALB),N-acetyl-beta-D-glucosaminidase(NAG) in patients with high altitude polycythemia(HAPC) at high altitudes and its relation with erythrocytes' biophysical property.Methods:38 patients with HAPC and 115 health volunteers were involved in this study,Urinary ALB、NAG、activity of red blood cell superoxide dismutase(RBC-SOD)、the level of malonyldialdehyde(MDA) and Erythrocyte filtration index(EIF) were detected.Results:Excretive amount of urinary ALB、NAG、and the level of plasma MDA、EFI were higher,and the activity of RBC-SOD was lower in patients with HAPC than those in healthy subjects,the changes were significantly obvious,Conclusions:EFI exerted an independent influence on urinary ALB and NAG.The increase in urinary ALB and NAG amount strongly correlated with the increase in EFI.The decrease of erythrocyte deformability caused by the increase of peroxidation of lipids might participate in the pathogenesis and progress of the increase of excretive amount of ALB and NAG in HAPC.

关 键 词：高原红细胞增多症 尿白蛋白 N-乙酰-β-D-氨基葡糖苷酶 红细胞流变学 脂质过氧化物 

分 类 号：R446.1[医药卫生—诊断学] R555+.1[医药卫生—临床医学]