糖尿病性肾病患者血浆内皮素水平的变化及其与肾功能的关系  

RELATIONSHIP BETWEEN ELEVATED PLASMA ENKETHELIN-1 LEVEL AND RENAL FUNC- TION IN PATIENTS WITH DIABETIC NEPHROPATHY

作　　者：王乐伟[1] 于志文[1] 毛腾淑[1] 黄大有 

机构地区：[1]北京医科大学人民医院内分泌科,北京医科大学第三医院内科

出　　处：《中华内科杂志》1995年第5期318-321,共4页Chinese Journal of Internal Medicine

摘　　要：采用放射免疫分析法测定了３３例正常人及９２例搪尿病性肾病不同时期患者血浆内皮素水平。结果显示，糖尿病患者血浆内皮素水平显著高于正常人；伴微量白蛋白尿、临床蛋白尿及肾功能不全的糖尿病性肾病患者血浆内皮素水平升高更显著，且呈依次递增。患者内皮素水平与糖化血红蛋白、血尿素氮、血肌酐及尿白蛋白排泄率呈显著正相关，与肾小球滤过率呈显著负相关。表明患者血浆内皮素水平与其肾功能受损程度及长期糖代谢紊乱有关，且与前者关系更为密切，提示内皮素可能在糖尿病性肾病的发生发展过程中有重要作用。Plasma endothelin-1(ET-1)level was measured with radioimmunoassay in 3 3 normal subjects and92patients with different stages of diabetic nephropathy,consisting of 35 cases of diabetes mellitus with nor-mal urinary albumin excretion(DM),22 cases of incipient diabetic nephropathy(IDN) ,22 cases of overtdiabetic nephropathy (ODN ), 8 cases with azotemia(DNa)and 5 cases with uremia ( DNu ),The resultsshowed that plasma ET-1 levels in DNa and DNu groups(30. 24±1. 93ng/L and 36. 38±3.62ng/L re-spectively)were significantly higher than those in other grotips(P< 0.05);ET-1 level in ODN group(20.50±0. 93ng/L)was significantly higher than those in DM and IDN groups(P<0. 001);ET-1 levelin IDN group was also significantly higher than that in DM1 group f17.79±0.74 vs。15. 06±0. 63ng/L,P<0.01);All the above values were significantly higher than that in normal subjects(7.08±0.22ng/L)(P<0.001).There was significant positive correlation between ET-1 level and HbAlc,systolic pressure,diastolic pressure,blood urea nitrogen, serum crea tine, uAER and a significant negative correlation be-tween ET-1 level and glomerular filtration rate. It is shown that progressive elevation of plasma ET-1 level is closely related with different stages of renal function impairment, suggesting strongly the role of ET-1 in the development and progression of diabetic nephropathy.

关 键 词：糖尿病 糖尿病性肾病 内皮素类 放射免疫分析 

分 类 号：R587.202[医药卫生—内分泌]