摘要
目的 :研究原发性高血压 (EH)病人的肾功能储备 (renal function reserve,RFR)以及某些影响因素。 方法 :2 7例 EH病人 (EH组 ) ,采血、留尿后 ,2小时内输入复方氨基酸 5 0 0 ml,1小时后再采血、留尿。测定氨基酸负荷前后的血压、血尿素氮、血及尿肌酐、肌酐清除率 ,血及尿一氧化氮、尿白蛋白、尿 α1 微球蛋白、尿视黄醇结合蛋白。同时选取 2 0例正常体检者作对照 (对照组 )。 结果 :EH组输氨基酸前 ,尿白蛋白、尿α1 微球蛋白、尿视黄醇结合蛋白异常分别为 17例、16例、2 5例 ,尿一氧化氮显著低于对照组 (P<0 .0 0 1)。氨基酸负荷后肌酐清除率、血与尿一氧化氮明显增加 (P<0 .0 5 ) ,RFR未减少 ,仍达到负荷前的 30 %。其他指标与负荷前比较无明显变化。 结论 :1作为监测早期肾功能损害的指标 ,RFR不如尿白蛋白、尿 α1 微球蛋白、尿视黄醇结合蛋白敏感。 2尿白蛋白、尿 α1 微球蛋白、尿视黄醇结合蛋白在氨基酸负荷后并无明显变化 ,说明短期的高滤过没有加重肾损害。3EH病人一氧化氮合成不足 ,尿一氧化氮明显降低 ;输入氨基酸后血与尿一氧化氮均显著上升 ,提示一氧化氮参与了氨基酸诱导的肾的血液动力学变化。
Objective:To study the renal function reserve(RFR)of patients with essential hypertension(EH)and the some impact factors on it. Methods:In 27 patients with EH,after collecting urine and blood specmens,500 ml amino acids solution were infused for 2h.After 1h,blood and urine were collected again.The blood pressure(BP),blood urea nitrogen(BUN),serum creatinine(Scr),urinary creatinine(Ucr)creatinine clearance rate(Ccr),serum and urinary nitric oxide(NO),urinary albumin(Ualb),urinary α 1 microglobulin(Uα 1 MG),urinary retinol binding protein(Urbp)were measured,before and after amino acids loading. Results:In patients with EH,before amino acids loading,Ualb,Uα 1 MG and Urbp were abnormal in 17/27,16/27,25/27 cases,respectively.Uno decreased significantly.After amino acids loading,Ccr Sno,Uno increased significantly(p<0 05),Ccr increased by 30%.While BP,Scr,BUN,Ualb,Uα 1 MG,Urbp had no significant changes(p>0 05). Conclusions:①As a marker of renal early damage,RFR is less sensitive than Ualb,Uα 1 MG or Urbp.②There are no significant changes in Ualb,Uα 1 MG,Urbp,after amino acids loading,it means that renal damage has not become more serious by a short time hyperfiltration.③There is an insufficient synthesis of NO in patients with EH.Uno decrease obviously.After amino acids infusion,Sno and Uno rise,NO may be involved in the renal hemodynamics change induced by amino acids.
出处
《中国循环杂志》
CSCD
北大核心
2000年第4期225-227,共3页
Chinese Circulation Journal
