肾病综合征水肿程度与血浆心钠素水平

The edema degree of nephrotic syndrome and the plasma level of atrial netruretic piptide

目的探讨心钠素在肾病综合征（NS）水肿形成中的作用。方法将NS患者分为重度水肿组和轻、中度水肿组。观察血浆ANP、尿钠、血浆蛋白、血清肌酐、尿素氮、血球压积（HCT）和晨尿比重等指标。结果重度水肿组血浆ANP水平较轻、中废水肿组和正常对照组低（P分别＜0．05和0．01）；UNaV明显减少（P均＜0.001）。轻、中度水肿组虽然血浆ANP含量正常，但UNaV却低于正常对照组（P＜0．05）。重度水肿组血浆白蛋白下降幅度较大，Scr和BUN增高，与轻、中度水肿组比较P分别＜0．01、0．05和0．05。结论重度水肿组血浆ANP下降反映有效循环血量不足；ANP通过影响肾小球滤过率和肾小管对钠水重吸收等环节。在NS原发性肾性钠潴留机制中发挥重要作用。

objective To study the effects of atrial netruretic piptide (ANP) on nephrotic edema. Methods Patients with nephrotic syndrome (NS)were divided into two groups according to their degrees of edema:severe and moderate edema groups. Plasma ANP,urinary Na excretion (UNaV),Scr and BUN of the patients were observed. Results Plasma level of ANP and UNaV in the patients of severe, edema were decreased significantly. The moderate group of edema were found lower in UNaV than normal patients- The severe group also showed remarkably lower plasma albumin and significantly higher Scr and BUN as compared with the moderate group- Conclusion The decrease of plasma ANP in patients of severe edema indicates insufficient circulatory plasma. ANP plays an important role in primary intrarenal mechanism of Na retention through affecting the glomerular filtration rale and re-absorption of sodium in renal tubule