糖尿病肾病患者血小板活性及血浆内皮素水平测定

Changes of plasma endothelin 1 levels and blood platelet activity in patients with diabetic nephropathy

为了解血小板活性及血浆内皮素１（ＥＴ１）水平在糖尿病肾病发生与发展中的作用，用放射免疫分析法与酶联免疫吸附分析法分别测定７８例不同程度糖尿病肾病患者血ＥＴ１和血小板α颗粒膜蛋白（ＧＭＰ１４０）、血栓素Ｂ２（ＴＸＢ２）及６酮前列环素Ｆ１α（６ＫｅｔｏＰＧＦ１α）含量。结果，糖尿病患者各组ＧＭＰ１４０与ＴＸＢ２水平分别高于对照组（Ｐ＜００５或Ｐ＜００１），肾功能不全组的ＧＭＰ１４０又高于其他肾病组（Ｐ＜００５）。糖尿病患者ＰＧＦ１α浓度则低于对照组（Ｐ＜００５），但肾病各组间比较无差异（Ｐ＞００５）。糖尿病肾病组各组ＥＴ１水平显著高于对照组（Ｐ＜００１或Ｐ＜０００１），且随肾病病变加重依次升高，各组间比较均有显著性差异（Ｐ＜００５）。结果提示：糖尿病肾病可能与血小板活性增高和血内皮素水平的升高导致肾脏血液动力学方面的改变，减少肾血流量，加重细胞缺血缺氧及直接刺激肾小球系膜细胞增生。

To study the effect of endothelin 1(ET 1) and blood platelet activity on the development and progression of diabetic nephropathy in patients.Plasma ET 1 and granule membrane protein(GMP 140),thromboxane B 2(TXB 2) and 6 keto prostaglandin F 1α (6 Keto PGF 1α )levels were measured respectively with radioimmunoassay and Enzyme Linked Immuno Sorbent assay(ELISA)in 15 normal subjects and 78 patient with different stages of diabetic nephropathy including 26 cases of diabetic mellitus without nephropathy,22 incipient diabetic nephropathy,22 obvious diabetic nephropathy and 10 diabetic nephropathy with renal insufficiency.The results revealed that plasma ET 1 levels in diabetic groups were significantly higher than those in normal subjects.The more severe renal function impairment,the higher ET 1 level.There was significantly positive correlation between plasma ET 1 level and glycosylated hemoglobin(HbAlc),mean arterial pressure,blood creatinine and urinary albumin excretion(uAER).The findings suggest that elevation of plasma ET 1 levels caused by disorder of glucose metabolism in long term may be closely related to the development and progression of diabetic nephropathy.Increase of blood platelet activity also may play an important role in pathogenesis of diabetic nephropathy.