【摘要】 目的测定高血压病(EH)患者尿微蛋白和N-乙酰-β-D葡萄糖苷酶(NAG)的排泄,间接了解肾单位受损的概貌。方法用放射免疫法和酶联免疫法测定了82例EH患者和30例正常对照者尿微量白蛋白(Alb)、转铁蛋白(Tf)、α1-微球蛋白(α1M),β2微蛋白(β2M)、Tamm-Horsfall蛋白(THP)及NAG活性。结果EH患者尿Alb、Tf、α1M、β2M、NAG均显著高于正常对照(P<0.05),而THP稍增高;各期及病程组Alb、Tf、α1M、NAG显著高于对照组(P<0.05),但Tf于Ⅰ、Ⅱ期增高,无显著差别;EH患者中有高血压家族史者尿Alb、α1M、β2M有增高趋势。结论EH患者早期即有肾单位受损,以肾小球和近曲小管为主,尚未及远曲小管;测定尿Alb、Tf、α1M、NAG可早期发现肾脏受损状况,有高血压家族史者肾受损无明显加重改变。更多还原

【Abstract】 Objective To investigate urinary excretion of micro-proteinuria and NAG(N-acetyl-β-D-glucosaminidase) in patients with essential hypertension(EH). Methods Urinary albumin(Alb),transferrin(Tf), α1-microglobulin(α1M), β2-microglobulin(β2M),Tamm-Horsfall protein(THP), and NAG activity were measured in 82 cases of hypertensive patients and 30 normotensive controls by radioimmunoassay and ELISA. Results The urinary excretion of Alb, Tf, α1M, β2M, NAG in EH were increased significantly than that of normotensive controls(P<0.05), but the THP did not change significantly in EH as comparing with controls. The urinary Alb,Tf,α1M, NAG were highter significantly in patients all stages(Ⅰ,Ⅱ,Ⅲ)and hypertentive duration(≤6 years,7～<11 years,≥11 years) than that of controls except that Tf in stage Ⅰ, Ⅱ. The patients with positive hypertensive family history the urinary Alb, α1M, were mild increased,no difference compared with that of negative family history. Conclusion The data suggest that renal injury might developed at an early stage in EH patients,the damage was involved mainly glomerulus and proximal convoluted tubule,not involved distal convoluted tubule yet. Determine the urinary Alb, Tf, α1M, NAG could find early nephrondamage.The patients with positive hypertensive family history renal injure might not more marked than that of negative family history.更多还原