慢性肾功能不全患者血浆内皮素、血栓素B_2及6-酮-前列腺素F_(1α)含量及其临床意义

Change in plasma endothelin,thromboxane B 2 and 6ketoprostaglandin F 1α concentrations in patients with chronic renal insufficiency and its clinical significance/

目的：观察慢性肾功能不全患者血浆内皮素（ＥＴ）、血栓素Ｂ２（ＴＸＢ２）和６酮前列腺素Ｆ１α（６ｋｅｔｏＰＧＦ１α）含量及其临床意义。方法：使用放射免疫分析法检测１４例氮质血症及１０例尿毒症患者血浆ＥＴ、ＴＸＢ２和６ｋｅｔｏＰＧＦ１α含量，并与正常对照组比较。结果：氮质血症组血浆ＥＴ为６５．３８±１９．１８ｎｇ／Ｌ，ＴＸＢ２为１０５．８４±９６．２４ｎｇ／Ｌ，６ｋｅｔｏＰＧＦ１α为３６．１４±３０．７２ｎｇ／Ｌ；尿毒症组ＥＴ为１２６．５０±５３．５５ｎｇ／Ｌ，ＴＸＢ２为３７２．６５±２８６．２２ｎｇ／Ｌ，６ｋｅｔｏＰＧＦ１α为２３．６２±１４．５６ｎｇ／Ｌ，均明显高于正常对照组。此外，结果还显示，血液透析（血透）后患者血ＥＴ含量显著下降（６４．１２±２５．１６ｎｇ／Ｌ与１２４．２８±５１．４１ｎｇ／Ｌ）。结论：慢性肾功能不全患者血浆ＥＴ含量升高，尤以尿毒症期为显著，血透后可降低。特别是早期血透对消除尿毒症高ＥＴ血症具有重要临床意义。本资料为临床应用ＥＴ拮抗剂治疗慢性肾功能不全提供参考依据。

Objective:To investigate change in plasma endothelin(ET),thromboxane B 2(TXB 2),and 6[CD*2]keto prostaglandin F 1α (6ketoPGF 1α )concentrations in patients with chronic renal insufficiency and its clinical significance.Methods:Plasma ET,TXB 2 and 6keto PGF 1α were measured in 24 patients with chronic renal insufficiency by immunoassay method.Results:Plasma ET,TXB 2 and 6ketoPGF 1α in patients with azotemia were 65 38±19 18ng/L,105 84±96 24ng/L,and 36 14±30 72ng/L,and in patients with uremia were 126 50±53 55 ng/L,372 65±286 22 ng/L,and 23 62±14 56 ng/L,respectively.Plasma ET,TXB 2 and 6ketoPGF 1α concentrations were markedly higher in patients with chronic renal insufficiency than in normal controls.Additionally,a significant decrease in plasma ET levels was found in patients after hemodialysis compared with pretreated levels (64 12±25 16 vs.124 28±51 41 ng/L).Conclusions:These results indicate that concentration of ET is markedly increased in patients with chronic renal insufficiency,especially in those with uremia.Early hemodialysis plays an important role in reduction of plasma ET in patients with uremia.Our data may provide evidence to support clinical use of ET antagonist in the treatment of chronic renal insufficiency.