流行性出血热患者四种体液因子变化及其临床意义

Plasma factors in epidemic hemorrhagic fever

目的：探讨流行性出血热患者血清肾素活性（ＰＲＡ）、血管紧张素Ⅱ（ＡＴⅡ）、内源性类洋地黄物质（ＥＤＬＳ）和心房利钠因子（ＡＮＦ）变化及其临床意义。方法：６３例９７份标本及对照组２６例４种体液因子均采用放免法测定。结果：４种体液因子在ＥＨＦ各病期中与对照组相比均有升高，但以低血压休克期和少尿期升高最为显著（Ｐ＜０．０５），其中，ＡＮＦ少尿期高于低血压休克期（Ｐ＜０．０５），而ＥＤＬＳ则相反。相关分析显示ＰＲＡ、ＥＤＬＳ、ＡＮＦ和ＡＴⅡ与ＢＵＮ、Ｃｒ呈正相关（Ｐ＜０．０１）。结论：ＰＲＡ、ＡＴⅡ、ＥＤＬＳ和ＡＮＦ均参与ＥＨＦ的发病过程，尤其在急性肾衰过程中起着重要作用。

Objective:To investigate pathogenic effects of plasma renin activity (PRA),angiotensin Ⅱ(AT Ⅱ),endogenous digitalis like substance(EDLS) and atrial natriuretic factor(ANF) in epidemic hemorrhagic fever(EHF).Methods:Plasma levels of PRA,AT Ⅱ,EDLS and ANF of 63 patients with EHF in different phases were detected by RIA.Results:All these factors were increased significantly in each phase of EHF and reached their highest levels in the hypotensive and oliguria phases.Atrial natriuretic factor was higher in oliguria phase than in hypotensive shock phase,whereas the level of EDLS was contrary to that of ANF.These factors are positively related to plasma BUN and Cr.Conclusions:These 4 factors play important role in pathogenesis of EHF,especially in acute renal failure of EHF.The interrelationship among these factors is also discussed in this article.