LN肾功能衰竭患者血液透析前后血管活性因子变化及临床意义

Significance of Changes of the Plasma Levels of Nitricoxide,Endothelin and Atrial Natriuretic Peptide in Patients with Lupus Nephritis Complicated with Renal Failure and Receiving Hemodialysis

目的:比较狼疮性肾炎(LN)肾功能衰竭患者血液透析前后血浆内皮素(ET)、一氧化氮(NO)及心钠素(ANP)含量变化并分析其临床意义。方法:32例LN肾功能衰竭患者采用硝酸还原法检测NO,放射免疫分析ET、ANP含量。结果:LN肾功能衰竭组NO、ET、ANP浓度明显高于正常对照组(P<0.05),且ET、NO及ANP水平升高的程度与肾功能损害的严重性呈正比;透析后NO和ANP显著下降(P<0.05),ET透析后有下降趋势,但与透析前相比无统计学意义(P>0.05)。结论:血管活性因子ET、NO及ANP参与了LN发病并加重其病情,血浆ET、NO及ANP浓度可作为判断LN患者肾功能损害程度的指标。血液透析后可以使LN肾功能衰竭组患者血浆NO及ANP含量明显降低。

Objective To investigate the clinical significance of changes of plasma levels of nitricoxide（NO）,endothelin（ET） and atrial natriuretic peptide（ANP） before and after hemodialysis in lupus nephritis（LN） patients with renal failure.Methods Plasma NO（with biochemistry） and ET,ANP（with RIA） levels were measured in 32 lupus patients with renal failure both before and after a course of hemodialysis and 32 controls.Results The plasma levels of NO,ET and ANP in the 32 LN patients with renal failure were significant higher than those in controls（P〈0.05） before hemodialysis,the NO,ET and ANP levels were positively correlated with the BUN and creatinine levels.After a course of hemodialysis,plasma NO and ANP decreased significantly（P〈0.05）,but no significant changes were observed in plasma ET levels.Conclusion The plasma level of NO,ET and ANP could help to assess the damage of renal function and hemodialysis could lower the level of NO and ANP in LN patients with renal failure.