尿N-乙酰-β-D氨基葡萄糖酶、丙氨酸氨肽酶和α1-微球蛋白检测在唑来膦酸致肾损伤早期诊断作用  

Effects of detecting of N-acety-beta-D-glucosaminidase,Alanine aminopeptidase and α1-microglobulin in urine on early diagnosis of kidney injury induced by zoledronic acid

作　　者：刘星[1] 刘大为[1] 谢晓冬[2] 郭占文[3] 郑振东[2] 张丽辉[4] 张娇蕊 刘永叶[2] 

机构地区：[1]沈阳军区总医院浑南门诊部,辽宁沈阳110016 [2]沈阳军区总医院肿瘤科,辽宁沈阳110016 [3]沈阳军区总医院放射治疗科,辽宁沈阳110016 [4]沈阳军区总医院第二干部病房,辽宁沈阳110016

出　　处：《临床军医杂志》2016年第4期398-401,共4页Clinical Journal of Medical Officers

基　　金：辽宁省自然科学基金(2011225021)

摘　　要：目的探讨尿N-乙酰-β-D氨基葡萄糖酶（NAG）、丙氨酸氨肽酶（AAP）和α1-微球蛋白（α1-MG）检测在唑来膦酸致肾损伤早期诊断中的作用。方法选取2012年2月至2014年7月沈阳军区总医院收治的100例应用唑来膦酸治疗的恶性肿瘤骨转移患者为研究对象。其中,男性48例,女性52例,年龄25~82岁,平均（60±11）岁。患者接受唑来膦酸注射液4 mg静脉滴注,1次/25~35 d,30 min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NAG、AAP、α1-MG和血肌酐（Scr）、尿素氮（BUN）水平。结果每次用药前、后比较尿NAG水平,差异均有统计学意义（P〈0.05）。第1次用药前后,尿α1-MG水平比较,差异无统计学意义（P〉0.05）;而第2次和第3次用药前后,尿α1-MG水平比较,差异有统计学意义（P〈0.05）。第1次和第3次用药前后,尿AAP水平比较,差异有统计学意义（P〈0.05）;而第2次用药前后,尿AAP水平比较,差异无统计学意义（P〉0.05）。每次用药前后,Scr、BUN水平比较,差异均无统计学意义（P〉0.05）。3次用药后,尿NAG、α1-MG水平组间比较,差异均有统计学意义（P〈0.05）;Scr、BUN水平组间比较,差异均无统计学意义（P〉0.05）。结论唑来膦酸致肾损伤患者尿NAG、AAP和α1-MG水平变化早于血肌酐。尿NAG、AAP和α1-MG联合检测可作为肾损伤的早期诊断指标。Objective To explore the effects of detecting of N-acety-beta-D-glucosaminidase（ NAG） ,Alanine aminopeptidase（ AAP） andα1-microglobulin（α1-MG） in urine on early diagnosis of kidney injury induced by zoledronic acid. Methods A total of 100 pa-tients comprised 48 males and 52 females with a mean age of （60 ± 11）years were enrolled into the study. 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. They received IV infusion of zoledronic acid 4 mg,once for 25 to 35 days,finished within 30 minutes. The therapy was ap-plied 3 times continuously. The patients′urine and venous blood samples were taken before and after each medication′s morning. The level of NAG,AAP and α1-MG in urine and serum creatinine,blood urea nitrogen were detected and compared. Results The differ-ence of level of NAG in urine before and after 3 times of medication were statistically significant（P〈0. 05）. The difference of level ofα1-MG in urine before and after 1 time of medication were not statistically significant（P〉0. 05）,but the difference of level ofα1-MG in urine before and after 2 and 3 times of medication were statistically significant（P〈0. 05）. The difference of level of AAP in urine before and after 1 and 3 times of medication were statistically significant（P〈0. 05）,but the difference of level of AAP in urine before and after 2 time of medication were not statistically significant（P〉0. 05）. The difference of level of serum creatinine and blood urea nitrogen were not statistically significant（P〉0. 05）. The difference of level of NAG and α1-MG in urine after 3 times of medication were statistically significant（P〈0. 05）. But the difference of level of serum creatinine were not statistically significant（P〉0. 05）. Conclusion The change in level of NAG,AAP and α1-MG in urine was earlier than that of serum creatinine,blood urea nitrogen in patient with kidne

关 键 词：唑来膦酸 N-乙酰-β-D氨基葡萄糖酶 丙氨酸氨肽酶 Α1-微球蛋白 急性肾损害 

分 类 号：R446[医药卫生—诊断学]