血液透析患者血浆肾上腺髓质素的变化

Plasma Adrenomedullin Levels in Hemodialysis Patients

目的 :探讨维持性血液透析 (HD)慢性低血压患者血浆肾上腺髓质素 (ADM )水平 ,观察低血压与血浆ADM的关系 .方法 :检测 16例有慢性低血压的HD患者及 2 1例非低血压的HD患者、 2 0例正常人血浆ADM水平 .结果 :HD低血压及非低血压患者血浆ADM水平显著高于正常人 (P <0 . 0 1,P <0 .0 1) ,HD慢性低血压组血浆ADM显著高于非低血压组 (P <0. 0 5 ) ,HD慢性低血压患者血浆ADM水平与平均动脉压 (MAP)呈显著负相关 (r =- 0 . 4 4 ,P <0 . 0 1) .结论 :HD患者血浆ADM升高 ,其中慢性低血压的HD患者升高更明显 ,HD慢性低血压患者血浆ADM与MAP显著相关 ,说明血浆ADM参与了HD低血压的病理生理过程 .

Objective: To measure plasma adrenomedullin (ADM) levels in hemodialysis (HD) patients; to analyze the correlation between the plasma ADM and HD patients with chronic hypotension.Methods: group of hypotensive ( N =16) HD patients, group of non-hypotensive HD patients ( N =21) and controls ( N =20) were included in the study and plasma ADM of 3 groups was measured.Results: The level of plasma ADM in HD patients with chronic hypotension and no hypotension was higher than controls (P<0.01;P<0.01), Plasma ADM level was higher in hypotensive group than that in no hypotensive group (P<0.05), The mean blood pressure was inversely correlated with the level of plasma ADM ( r =-0.44,P<0.01) in HD patients with chronic hypotension.Conclusion: The level of Plasma ADM increases in HD patients, but higher in hypotensive group than in no hypotensive group, The level of plasma ADM is higher in hypotensive group and inversely correlated with mean arterial pressure, which suggests that ADM may be involved in pathophysiological course of chronic hypotension in HD patients.