乙型肝炎与肾素—血管紧张素—醛固酮系统的关系

The Relationship between Hepatitis B and Renin-Angiotensin-Aldosterone System

作者用放射免疫法测定了30例(68例次)乙型肝炎(乙肝)患者和35名正常人的血浆血管紧张素Ⅱ(AT Ⅱ)水平。结果表明,30例乙肝患者AT Ⅱ明显高于35名正常人;各型乙肝患者AT Ⅱ升高值与病情轻重一致,8例肝肾综合征(HRS)患者ATⅡ显著高于未并发HRS者。用巯甲丙脯酸(CPT)治疗后,ATⅡ明显下降,肾功能改善。提示AT Ⅱ升高可能是HRS发生的原因之一,CPT可能抑制了ATⅡ的产生,对HRS有一定疗效。

The angiotensin Ⅱ(ⅡAT)les in plasma were measured 68 timesby using radio-immunoassay in 30 patientswith viral hepatitis B(HB)and in 35healthy persons as the control group. Theresults showed that the AT Ⅱ levels ofpatients with HB were much higher thanthose of the control group (P<0.001).They were 219. 25±191.31ng/L and 60.70±10.73 ng/L, respectively. These indicatedthat the renin-angiotensin-aldosteronesystem(RAAS) of the patients was inexciting state. The levels of 8 cases ofsevere chronic aotive hepatitis(SCAH)(ATⅡ=270.40±106.55ng/L, 6 cases ofsubacute fulminant hepatitis (SFH) (ATⅡ=332.80 140.12 ng/L), and 4 cases ofhepatocirrhosis (HC) (AT Ⅱ=218.50±97.64pg/ml)were all higher than those of 8cases of chronic active hepetitis (CAH)(100.50±83.81ng/L) and those of 4 casesof acute icteric hepatitis (AIH) (123.33±64.97ng/L).These findings showed thatthe levels of AT Ⅱ were directely relatedwith the severity of the illness. The AT Ⅱlevels of 8 cases of HRS (270.50±66.31ng/L) were higher that those withoutHRS(174.501±78.48ng/L).After treatmentwith captopril(CPT), the renal functionof the patients returned to normal andthe patients got better, while the AT Ⅱlevels decreased greatly. The results sug-gested that high AT Ⅱ levels in plasmamay be one of the causes aggressing theHRS.The CPT may inhibit the produceof AT Ⅱ and there are some therapeuticeffects for the HRS.