血液透析前后患者血浆内皮素与降钙基因相关肽的变化

Significance of changes in endothelin and calcitonin gene related peptide levels in patients during hemodialysis

目的：探讨内皮素（ＥＴ）与降钙基因相关肽（ＣＧＲＰ）在血液透析（ＨＤ）患者透析前后含量变化规律及它们在高血压病发生发展中的作用。方法：采用放射免疫分析法对３５例维持性ＨＤ患者进行了血浆ＥＴ与ＣＧＲＰ检测。结果：正常人血浆ＥＴ为５６．４６±１８．４９ｎｇ／Ｌ，ＣＧＲＰ为５１．２７±２０．２３ｎｇ／Ｌ。ＨＤ患者透析前后血浆ＥＴ含量（１４８．８８±４２．９６ｎｇ／Ｌ和１１９．６７±３９．５２ｎｇ／Ｌ）均显著高于正常对照组（Ｐ均＜０．０１）。ＨＤ后血浆ＥＴ明显低于ＨＤ前（Ｐ＜０．０５）。ＣＧＲＰ含量在ＨＤ前（３２．０８±１９．１６ｎｇ／Ｌ）明显低于正常对照组（Ｐ＜０．０１），ＨＤ后显著增高（８２．２２±６２．２３ｎｇ／Ｌ），与正常对照组比较增高极为显著（Ｐ＜０．０１）。ＨＤ患者高血压组血浆ＥＴ水平在透析前后（１６０．４４±４２．３４ｎｇ／Ｌ，１４１．１２±３６．８７ｎｇ）均明显高于血压正常组（１２０．４４±２９．７５ｎｇ／Ｌ，９４．３８±２０．４２ｎｇ／Ｌ），Ｐ均＜０．０５。同时ＨＤ前血浆ＥＴ含量的增高与ＣＧＲＰ含量的减少呈显著负相关（ｒ＝－０．８９，Ｐ＜０．０５）。ＨＤ后血浆ＥＴ的下降与ＣＧＲＰ的升高亦呈显著负相?

Objective:To study change in plasma endothelin (ET) and calcitonin gene related peptide(CGRP) levels and its significance in patients during hemodialysis (HD).Methods:Plasma ET and CGRP levels were measured in 35 patients with maintenance HD by radioimmunoassay.Results:Plasma levels of ET and CGRP in normal subjects were 56 46±18 49 ng/L and 51 27±20 23 ng/L,respectively.Following HD,plasma ET level significantly decreased ( P <0 05),but it was still higher than that in normal subjects( P <0 01).To the contrary,plasma CGRP level was lower in patients before HD than that in normal subjects,but it was significantly elevated after HD ( P <0 01).ET levels in patients with hypertension were markedly higher than that in patients without hypertension both before and after HD ( P <0 01).Moreover,significant correlations were found between ET and CGRP levels both prior to HD( r =-0 89, P <0 05)and postHD( r =-0 81, P <0 05).Conclusions:Those results demonstrate that ET and CGRP play an important role in the development of hypertension in HD patients.