CAJ | 학술논문

对36例肾移植患者肾移植前与术后8周内的肾小管泌氢功能,包括尿pH、可滴定酸(TA)、NH4+、酸净排出量(NAC)及HCO2-浓度进行动态监测,以探讨该试验在术后监测中的价值.结果发现,移植前pH及HCO3-明显高于正常,TA、NH4+及NAC明显低于正常.移植后肾功能稳定恢复组的五个参数均逐渐恢复,其中完全恢复正常者占62.5%;排斥组出现排斥反应时TA、NH4+及NAC含量下降,随排斥逆转而有所恢复,完全达正常者占37.5%;肾失功组患者TA、NH1+及NAC始终波动于低水平,而pH与HCO2-增高.结果表明,肾移植术后动态监测肾小管泌氢功能对了解移植肾功能状态、预测排斥反应的发生以及判断疗效和预后具有一定参考价值.
대36례신이식환자신이식전여술후8주내적신소관비경공능,포괄뇨pH、가적정산(TA)、NH4+、산정배출량(NAC)급HCO2-농도진행동태감측,이탐토해시험재술후감측중적개치.결과발현,이식전pH급HCO3-명현고우정상,TA、NH4+급NAC명현저우정상.이식후신공능은정회복조적오개삼수균축점회복,기중완전회복정상자점62.5%;배척조출현배척반응시TA、NH4+급NAC함량하강,수배척역전이유소회복,완전체정상자점37.5%;신실공조환자TA、NH1+급NAC시종파동우저수평,이pH여HCO2-증고.결과표명,신이식술후동태감측신소관비경공능대료해이식신공능상태、예측배척반응적발생이급판단료효화예후구유일정삼고개치.
H+ secretion functions were examined in 36 patients with chronic renal failure (CRF)before and after renal transplantation.The results showed that the patients had higher uri-nary pH,HCO3- and lower titrable acid(TA),NH4+ and net acid excretion(NAC) levels before operation than those in normal control.These parameters returned to normal levels in patients with well functioning grafts after operation.The TA,NH4+ and NAC levels decreased in Datients with rejection episodes and could return to normal levels after the reverse of rejection but they were persistently low in patients with irreversible acute rejection with pH and HCO3- staying at high levels.Our results suggested that the monitoring of tubular H+ secretion function might provide valuable information about renal function status and prognosis.