慢性肾功能不全患者血中内皮素和一氧化氮检测的临床意义

Clinical significance of blood endothelin and nitric oxide in patients with chronic renal failure

目的：了解内皮素（ＥＴ）与一氧化氮（ＮＯ）在慢性肾衰患者中的变化。方法：按肾功能分期，将２９例慢性肾衰患者分为肾功能不全代偿期组、氮质血症期组、尿毒症期组，分别用放射免疫分析法和铬还原法测定其血浆ＥＴ和血清ＮＯ。结果：伴肾功能减退者血浆ＥＴ水平明显升高，ＮＯ水平并不下降，且在尿毒症组异常升高；ＥＴ水平与肾功能损害程度及肾性高血压严重度呈正相关，而ＮＯ则无相关性；血透后ＥＴ值进一步升高，而ＮＯ则明显下降。结论：认为ＥＴ和ＮＯ水平的异常可能与肾功能损害有关。

Endothelin(ET) is a very potent vasoconstrictor which can obviously reduce renal blood flow and glomerular filtration rate(GFR) by interacting with ET receptors. Nitric oxide(NO) is a strong vasorelaxing factor which modulates renal blood flow(RBF), GFR and tubular sodium bsorption. The balance of ET and NO influences renal hemodynamics. Twenty nine patients with chronic renal failure(CRF) were enrolled in this study, and 25 health adult set as control. CRF patients were divided into 3 subgroups according to their serum creatinine levels. Plasma ET was measured by radioimmunoassay and serum NO determined by the assay of chromium reduction. RESULTS 〖WTBZ] Plasma ET was significantly elevated in CRF patients(123.3±59.4 BHDW) as compared to the normal control(50.8±7.6BHDW)( P <0.05). It was positively correlated with the degree of renal function impairment and the severity of hypertension. Serum NO was also elevated in CRF patients(84.6±62.6BHDW) as compared to the control(52±13BHDW). No difference was found in serum NO between CRF subgroups with different degrees of renal function impairment. Elevated blood ET and No levels are observed in CRF patients, these changes may be related to the decrement of renal filtration.