NIDDM 患者血浆ET RIA与肾功能损害关系的探讨

CHANGES OF PLASMA ENDOTHELIN LEVELS AND THEIR RELATIONSHIP WITH RENAL FUNCTIONS IN NIDDM PATIENTS

为了探讨血浆内皮素(Endothelin,ET)与糖尿病慢性微血管病变-糖尿病肾病肾功能损害的关系。本文采用放射免疫分析法(RIA)对43例非胰岛素依赖型糖尿病(NIDDM)患者及28例健康对照者血浆中的ET水平进行了观察,并将其与尿β_2-微球蛋白(β_2-m)排泄率、白蛋白(Alb)排泄率、Tamm Horsfall糖蛋白(THP)排泄率、总蛋白(TP)排泄率、血尿素氮(BUN)及肌酐(Cr)含量之间的相互关系进行了分析。结果发现,NIDDM患者中,不伴肾功能损害者,其ET水平与健康成人比较无显著性差异(p>0.05),而伴肾功能损害者,其ET水平则明显高于健康成人(p<O.01),且肾功能损害越重者,其ET水平增高越明显等相关分析发现,伴肾功能损害者的ET与Alb呈显著正相关(n=27,r=0.42,p<0.05)。提示NIDDM患者ET代谢失常,可能是糖尿病肾病形成及发展机制中的一个重要方面。

To investigate the changes of plasma endothelin level and their relation-ship with renal functions in patients with non-insulin-dependent diabetes mellitus(NIDDM), plasma endothelin concentrations were measured by RIA in 43 patients with NIDDM and 28 healthy controls. Urinary excretion rates of β2-microglobulin, albumin, Tamm Horsfall protein and total protein were studied. The results showed: (1) plasma endothelin concentrations were significantly elevated in NIDDM patients with renal dysfunction as compared with those in healthy controls and NIDDM patients without renal dysfunction (p<0.01); (2) there were no difference in plasma endothelin concentrations between healthy controls and NIDDM patients without renal dysfunction (p>0.05); (3) plasma endothelin concentrations were positively correlated with urinary excretion rate of albumin in NIDDM patients with renal dysfunction (n = 27, r = 0.42,p<0.05). These findings suggested that the abnormalmetabolism of endothelin might play an important role in the development of diabetic nephropathy in NTDDM patients.