原发性高血压肾功能损害患者血浆肾上腺髓质素及内皮素的改变

Changes of plasma adrenomedullin and endothelin in essential hypertensive patients with renal impair

目的观察肾上腺髓质素(ADM)及内皮素(ET)在原发性高血压肾功能损害患者血浆浓度的改变,探讨ADM及ET在高血压肾功能损害时的意义。方法用特异性的放射免疫法(RIA)测定18例健康志愿者及52例原发性高血压患者[36例Ⅰ期高血压(Ⅰ期组),16例高血压合并肾功能损害(肾损组)]。血浆ADM及ET的浓度。结果Ⅰ期组血浆ADM和ET水平较正常组显著升高,而肾损组血浆ADM、ET水平较Ⅰ期组又显著升高(P<0.01)。高血压时血浆ADM、ET水平与BUN Cr水平呈显著正相关,与肾小球滤过率(GFR)呈显著负相关。结论血浆ADM、ET水平与肾功能关系密切。ADM可能是为抵消ET等缩血管物质在高血压时的过度分泌而代偿性地合成、释放增多,对肾脏起保护作用。

Objective To assess the change of plasma adrenomedullin(ADM)and endothelin(ET)in patients with essential hypertensin. Methods Concentrations of plasma ADM and ET were measured in 18 healthy control subjects and 52 patients with essential hypertension, 36 patients of which had no target organ damage, while 16 patients of which were complicated with renal impair. Results The concentrations of ADM and ET were significantly higher in patients with renal impair than in patients without organ damage. Plasma concentrations of ADM and ET were strongly positively correlated with blood urea nitrogen levels and serum creatinine levels. A strong inverse correlation between GFR and plasma concentrations of ADM and ET was found. Conclusion The increase of plasma ET and ADM may have an intimate relation to the renal function. ADM and ET may play some important role in the pathophysiologic makeup of hypertension and hypertension with renal dysfunction. ADM may act against excessive vasoconstrictor ET increased in essential hypertension and may be part of a compensatory mechanism to offset further development of renal impair.