血浆NO、ET、ANP、PRA、AT在慢性肾功能衰竭患者透析前后的变化及其意义

Changes of Plasma NO,ET,ANP,PRA and AT in Patients with Chronic Renal Failure before and after Dialysis

[目的]探讨慢性肾功能衰竭(CRF)患者血浆一氧化氮(NO)、内皮素(ET)、心房利钠多肽(ANP)、肾素活性(PRA)、血管紧张素(AT)在透析前后的变化及其临床价值.[方法]选取在两院进行血液透析的CRF患者(CRF组,n=40)以及健康体检者(正常对照组,n=40)作为研究对象.比较两组及CRF组透析前后血浆NO、ET、ANP、PRA、AT变化情况.[结果]CRF组患者透析前血浆NO、ET、ANP、PRA、AT水平均显著高于正常对照组(P<0.05);CRF组患者透析后血浆NO、ANP水平显著低于透析前,血浆PRA、AT水平显著高于透析前,且差异均有统计学意义(P<0.05),两组透析前后血浆ET水平比较,差异无统计学意义(P>0.05).[结论]血液透析治疗会导致CRF患者血浆NO和ANP水平下降,PRA和AT水平升高,同时ET水平有略微下降,表明CRF患者血浆NO、ET、ANP、PRA、AT水平变化会随着透析治疗发生较大的改变,且各指标间影响情况较为复杂,临床应用中需要参考各指标具体诊断.

【Objective】To investigate the changes and clinical value of plasma nitric oxide(NO),endothelin(ET),artial natriuretic polypeptide(ANP),renin activity(PRA)and angiotensin(AT)in patients with chronic renal failure(CRF)before and after dialysis.【Methods】The patients with chronic renal failure and healthy people in our hospital were selected as the research subjects.There were 40 cases in the CRF group and 40 cases in the control group.The levels of plasma NO,ET,ANP,PRA and AT were measured before and after dialysis.Healthy volunteers in the control group received all measurements as well.The changes of indexes were compared between the CRF group and the control group;And they were also compared before and after dialysis in the CRF group.【Results】The levels of plasma NO,ET,ANP,PRA and AT in the CRF group were significantly higher than those in the normal control group(P<0.05).Compared to before dialysis,plasma NO and ANP levels were significantly lower in the CRF group after dialysis(P<0.05),while levels of plasma PRA and AT were significantly higher(P<0.05).There was no significant difference in plasma ET level of the CRF group before and after dialysis(P>0.05).【Conclusion】Hemodialysis treatment can lead to a decrease in plasma NO and ANP levels,an increase in PRA and AT levels,and a slight decrease in ET level,which indicate changes of plasma NO,ET,ANP,PRA,and AT levels in patients with chronic renal failure during hemodialysis.However,the impact of changes among those indicators is more complicated.In clinical application,it is necessary to refer to the specific diagnosis of each indicator.