肾实质性高血压患者血浆肾上腺髓质素测定的初步分析

Preliminaryanalysisofdetectingplasmaadrenomedulininpatientswithrenalparenchymalhypertension

探讨肾实质性高血压（ＲＰＨ）时肾上腺髓质素水平变化。方法应用放免法测定了１１例肾实质性高血压、３３例原发性高血压（ＥＨ）和２５例正常人的血浆肾上腺髓质素［ＡＤＭ（１３－５２）］、内皮素－１（ＥＴ－１）、血管紧张素Ⅱ（ＡＴⅡ）水平。结果肾实质性高血压患者ＡＤＭ（１３－５２）、ＥＴ－１较ＥＨ和正常人明显增高，ＡＴⅡ较正常人高但与ＥＨ组相似；ＡＤＭ（１３－５２）与ＥＴ－１、ＢＵＮ、平均动脉压（ＭＡＰ）有显著的正相关关系，与ＡＴⅡ无相关性。结论肾实质性高血压患者血浆ＡＤＭ（１３－５２）增高可能是继发于高血压代偿性分泌增多，并可能与肾功能减退代谢障碍。

bjectiveToinvestigatethechangeofadrenomedulin[ADM(13-52)]inpatientswithrenalparenchymalhypertension(RPH).MethodsADM(13-52)、endothelin-1(ET-1)andangiotensinⅡ(ATⅡ)weredetectedwithradioimmunoassayin11casesofPRH,33casesofessentialhypertension(EH)and25healthypersons.ResultsADM(13-52)andET-1washighersignificantlyinRPHthanincontrolandsimilartoEH;ADM(13-52)wasposi-tivelycorrelatedtoET-1、BUNandmeanarterypressure(MAP),notcorrelatedtoATⅡ.ConclusionIncreasingADM(13-52)inRPHmaybesecondarytocompensatoryelevationofexcretioninhypertensionandrelatedtothedecreasedeliminationandrenalinsuficiency.