慢性肾小球肾炎患者尿内皮素-1的变化及临床意义

The Clinical significance of changed urinary endothelin-1 in chronic glomerulonephritis patients

目的探讨尿内皮素-1(ET-1)与原发性肾小球肾炎肾功能损害的关系。方法正常对照组15例,原发性慢性肾小球肾炎38例。根据内生肌酐清除率(Ccr)将患者分为四组:Ⅰ组(Ccr≥50ml/min),Ⅱ组(20ml/min≤Ccr<50ml/min),Ⅲ组(10ml/min≤Ccr<20ml/min),Ⅳ组(Ccr<10ml/min)。Ⅰ组中根据尿蛋白量分为ⅠA与ⅠB两组。采用放射免疫法检测各组尿中ET-1的浓度。结果与对照组相比,Ⅰ、Ⅱ、Ⅲ、Ⅳ组尿ET-1显著性升高(P值均<0.01),各组间亦有显著性差异(F=66.17,P<0.01)。在Ccr相似情况下,尿蛋白多者(ⅠB组),尿ET-1较高。尿ET-1与24小时尿蛋白量、Scr呈正相关,r值分别为0.4458(P<0.005)、0.8046(P<0.001)。结论检测尿ET-1在一定程度上可判断慢性肾炎的预后和转归。

Objective To study the clinical significance of the changed urinary endothelin-1（ET-1） in renal dysfunction of primary glomerulonephritis. Methods The urinary ET-1 was measured by mdioimmuoassay in 15 normal subjects and 38 patients with primary glomerulonephritis. The patients were divided into four groups according to the levels of their Ccr. group Ⅰ （Ccr≥50ml/min）, Ⅱ （20ml/min≤Ccr50ml/min）, Ⅲ（10ml/ min≤Ccr〈20ml/min）, Ⅳ（Ccr〈10ml/min）. Results Compared with control group（78.65±8.43pg/umol.cr）, there was a significant elevation in the levels of the urinary ET-1 of groups Ⅰ , Ⅱ ,Ⅲ ,Ⅳ（106.57±21.17,128.88±9.14, 150.88±12.55,167.50±15.18pg/umol.cr, respectively; P〈0.01）,and when compared ench other, a significant difference was also found between that of them（F=66.17, P〈0.01）. In the ease of same Ccr, the more the urinary protein, the higher was the urinary ET-1 concentration, which was positively correlated with urinary protein（r= 0.4458;P〈0.005） and Scr（r=0.8046; P〈0.001）. Conclusion It is potentially useful to measure the urinary ET-1 in predicting the prognosis and outcome of patients with chronic glomerulonephritis to a certain degree.