鱼胆中毒致急性肾衰竭患者血浆内皮素的变化

The clinical changes of plasma endothelin in patients with acute kidney function failure induced by fish bile poisoning

目的 探讨鱼胆中毒患者血浆内皮素 (ET)水平的变化特点与急性肾衰竭 (ARF)发生、发展的关系。方法 采用放射免疫法测定并比较 3 5例鱼胆中毒并发ARF患者、3 0例单纯鱼胆中毒患者以及 2 0名健康人血浆ET水平 ,分析对比治愈组和死亡组ET水平。结果 鱼胆中毒并发ARF组血浆ET水平 13 0 .8± 60 .5ng/L比正常对照组 5 1.6± 9.2ng/L显著升高 (P <0 .0 1) ,单纯鱼胆中毒组血浆ET水平 63 .3± 10 .5ng/L与正常对照组比较差别无显著性 (P >0 .0 5 ) ;鱼胆中毒治愈组和死亡组ET水平分别为 78.6± 2 5 .9ng/L和 2 2 7.8± 82 .6ng/L ,差异有高度显著性 (P <0 .0 1)。结论 ET参与了鱼胆中毒并发ARF的发生与病情的进展 ,血浆ET水平可作为判断鱼胆中毒患者病情和预后的一个重要临床指标。

Objective To investigate the re la tionship of the plasma endothelin (ET) changes in paitents with fish bile poison ing and the progression of acute renal failure (ARF). Methods A radioimmunity method was used to measure the plasma ET levels in patients the ET levels in 35 patients with fish bile poisoning associated wi th ARF, in 30 patients with fish bile poisoning alone, and 20 healthy individual s. The comparison of ET levels in the curative group to those in the death group had also been done. Results The ET level (130. 8±60.5ng/L) in the fish bile poisoning associated with ARF group, which was sta tistically higher than that in the control group (51.6±9.2ng/L); there was no statistically significant difference in comparison of the plasma ET level (63 .3±10.5ng/L) in the pure fish bile poisoning group to that in the control group (P>0.05); the ET levels in the curative fish bile poisoning group and the d eath group were 78.6±25.9ng/L and 227.8±82.6ng/L, respectively, there was stat istically significant difference (P<0.01). Conclusion ET is involved in the attack and the progression of the fish bile po isoning associated with ARF, plasma ET level can be a clinical marker for predic ting fish bile poisoning condition and prognosis.