慢性肾病患者血浆内皮素、心钠素变化及其与中医辨证分型的关系

Relationship between Changed of Plasma ET and ANP in Chronic Kidney Disease Patients and Syndrome Differentiation and Typing of Traditional Chinese Medicine

目的 :探讨慢性肾病患者血中ET、ANP变化及其与中医辨证分型的关系。方法 :采用放射免疫分析法检测了 68例慢性肾病患者血中ET、ANP水平 ,并与 32例健康人对照。结果 :慢性肾病患者血中ET、ANP水平均明显高于健康对照组 (P <0 0 1) ,慢性肾衰组ET、ANP水平明显高于肾功能正常组 (P <0 0 1或P <0 0 5)。中医辨证分型显示 :ET水平依次是脾肾阳虚 >肝肾阴虚 >气阴两虚 >肺肾气虚 ;ANP水平依次是脾肾阳虚 >肺肾气虚 >气阴两虚 >肝肾阴虚。结论 :血中ET、ANP水平的变化在慢性肾病的发生、发展中具有重要的作用 ,其升高可以反映肾功能的受损程度 ,并与中医辨证分型有一定的内在联系。

Objective:To explore relationship between Changed of plasma Endothelin (ET) and Atrial Natriuretic polypeptide (ANP) in chronic kidney disease patients and syndrome differentiation and typing of Traditional Chinese Medicine (TCM). Methods: By means of radionimmunoassay, plasma ET and ANP of 68 case of chronic kidney disease patients and 32 health controls were determined respectively. Results: Level of plasma ET and ANP of Chronic kidney disease patients were higher than that of healthy controls group (P<0.01), the level of plasma ET and ANP of chronic renal failure (CRF) group were higher than normal kidney function group (P<0.01 or P<0.05), while very significant positive correlation were found between plasma ET and ANP with Cr(P<0.01 or P<0.05). Syndrome differentiation and typing in TCM showed that level of plasma ET was spleen Yang and kidney Yang deficiency>liver Yin and kidney Yin deficiency>both Qi and Yin deficiency>lung Qi and kidney Qi deficiency, that level of plasma ANP was spleen Yang and kidney Yang deficiency>lung Qi and kidney Qi deficiency>both Qi and Yin deficiency>liver Yin and kidney Yin deficiency . Conclusions: Changes of level of plasma ET and ANP may play an important role in the pathogenesis of Chronic kidney disease. It is higher not only showed degree of renal function failure, but also were intrinsic connection with syndrome differentiation and typing in TCM.