尿γ-谷氨酰转移酶和亮氨酸氨基肽酶检测在唑来膦酸致肾损伤早期诊断中的作用  

Effects of detecting of γ-glutamyltransferase and leucine aminopeptidase in urine on early diagnosis of kidney injury induced by zoledronic acid

作　　者：刘大为[1] 刘星[1] 张娇蕊 郭占文[2] 谢晓冬[3] 李佳[2] 英媛媛 郑振东[3] 张丽辉[3] 季发和[3] 

机构地区：[1]沈阳军区总医院浑南门诊部,110168 [2]沈阳军区总医院放射治疗科 [3]沈阳军区总医院肿瘤科

出　　处：《药物不良反应杂志》2015年第6期412-414,共3页Adverse Drug Reactions Journal

基　　金：辽宁省自然科学基金（2011225021）

摘　　要：目的探讨尿γ-谷氨酰转移酶（γ-GT）和亮氨酸氨基肽酶（LAP）检测在唑来膦酸致肾损伤早期诊断中的作用。方法研究对象为2012年2月至2014年7月在沈阳军区总医院应用唑来膦酸治疗的恶性肿瘤骨转移患者。患者接受唑来膦酸注射液4mg静脉滴注，1次／25—35d，30min滴完，连续应用3次。每次用药前和用药次日留取患者清晨尿液及静脉血，检测并比较尿γ-GT、LAP和血清肌酐（Scr）水平。结果100例患者纳入研究，男48例，女52例，年龄25—82岁，平均（604-11）岁。第1次应用唑来膦酸前、后尿γ-GT、LAP和Scr分别为（7±5）、（84-5）U／L，（3324-110）、（375±113）nmol·s-1·L-1和（52±12）、（54±12）mol／L；第2次用药前、后分别为（10±4）、（12±5）U／L，（407±104）、（460±126）nmol·S-1·L-1和（51±13）、（53±13）μmol／L；第3次用药前、后分别为（16±8）、（19±9）U／L，（549±159）、（662±199）nmol·S-1·L-1和（52±15）、（53±14）umol／L，3次用药前、后比较尿γ-GT、LAP水平差异均有统计学意义（均P〈0．05），而Scr水平差异均无统计学意义（均P〉0．05）。3次用药后尿γ-GT、LAP水平两两比较差异均有统计学意义（均P〈0．05），Scr水平差异均无统计学意义（均P〉0．05）。结论唑来膦酸致肾损伤患者尿γ-GT、LAP水平变化早于Scr；尿γ-GT、LAP可作为。肾损伤的早期诊断指标。Objective To explore the effects of detecting of γ-glutamyhransferase （γ-GT） and leucine aminopeptidase （LAP） in urine on early diagnosis of kidney injury induced by zoledronic acid. Methods The patients with malignant tumor bone metastasis and received zoledronic acid from February 2012 to July 2014 in the General Hospital of Shenyang Military Command were enrolled into this study. The patient received IV infusion of zoledronic acid 4 mg, once for 25 to 35 days, finished within 30 minutes. The therapy was applied 3 times continuously. The patients＇ urine and venous blood samples were taken before and after each medication＇s morning. The levels of γ-GT, LAP in urine and serum creatinine were detected and compared. Results A total of 100 patients comprised 48 males and 52 females with a mean age of （60 ± 11 ） years （25-82 years） were enrolled into the study. The levels of γ-GT, LAP in urine and serum creatinine before and after receiving zoledronic acid in the first time were （8 ± 5 ）, （7 ± 5 ） U/L; （332 ±- 110）, （375 ±113） nmol· s-1 ·L-a; （52 ± 12）, （54 ± 12） txmol/L, respectively. The levels of γ-GT, LAP in urine and serum creatinine before and after receiving zoledronic acid the second time were （ 10 ± 4） , （12 ± 5 ）U/L; （407 ± 104）, （377 ± 126 ） nmol· s-1· L-1; （51 ± 13 ）, （53 ± 13 ）umol/L, respectively. The levels of γ-GT, LAP in urine and serum creatinine before and after receiving zoledronic acid the third time were （16 ±8）,（19±9）U/L; （549 ±159）,（662±199） nmol· s-1· L-1; （52±15）,（53±14） umol/L, respectively. The differences of levels of γ-GT, LAP in urine before and after 3 times of medication were statistically significant （ all P 〈 0.05 ）. But the differences of levels of serum creatinine were not statistically significant （all P 〉 0.05 ）. The differences of levels of γ-GT, LAP in urine after 3 times of medication were statistically significant （ all P 〈 0.05 ）. Bu

关 键 词：唑来膦酸 Γ-谷氨酰转移酶 亮氨酰氨肽酶 急性肾损害 

分 类 号：R969[医药卫生—药理学]