肾综合征出血热若干体液因子和肾脏血液动力学变化的关系  

The Changes of Several Humoral Factors and Renal Hemodynamics in Hemorrhagic Fever with Renal Syndrome

作　　者：孙志坚[1] 黄湘虎[1] 王明秀[1] 陆北川[1] 李锡官 唐季和 包荫堂[1] 姚薇萱[1] 徐兆强[1] 林戟 马玉琪[1] 常国钧[1] 

机构地区：[1]南京医科大学传染病学教研室

出　　处：《中华实验和临床病毒学杂志》1995年第3期235-238,共4页Chinese Journal of Experimental and Clinical Virology

摘　　要：研究了２８例肾综合征出血热（ＨＦＲＳ）患者体液因子和肾脏血液动力学的变化。用放射免疫法检测了血浆内皮素（ＥＴ）、Ｐ物质（ＳＰ）、血栓素Ｂ２（ＴＸＢ２）、６－酮－前列腺素Ｆ１α（６－ｋ－ＰＧＦ１α）及血管紧张素－Ⅱ（ＡＴ－Ⅱ）的含量，用放射性核素计算机扫描成像摄影法（ＥＣＴ）测定了肾小球滤过率（ＧＦＲ）和肾有效血浆流量（ＥＲＰＦ），结果发现，ＨＦＲＳ患者从发热期至多尿初期血浆ＥＴ、ＴＸＢ２、ＡＴ－Ⅱ均高于正常水平，而血浆ＳＰ则低于正常水平，６－Ｋ－ＰＧＦ１α除低血压少尿期外其他各期亦都低于正常。ＧＦＲ与ＥＲＰＦ从发热后期至多尿期均明显下降，及至恢复初期多数重型患者仍未恢复正常。上述结果提示体液因子的平衡失调是造成内脏缺血和急性肾功能衰竭的重要因素，如采取适当措施抑制编血管物质的强烈作用，则有利于循环的恢复。Some of humoral factors and renal hemodynamics were studied in 28 cases with hemorrhagic fever with renal syndrome (HFRS). Plasma endothelin(ET), Substance P,(SP) thromboXane B2 (TXB2), 6-keto-prostaglandin F1α(6-K-PGF1α)and angiotensin-Ⅱ(AT-Ⅱ) were detected with radioimmunoassay (RIA), and glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were detected with emission computerized tomography (ECT). The results showed that in the first three phases of HFRS the concentrations of plasma ET, TXB2 and ATⅡwere much higher than those of normal level,plasma SP and 6-k-PGF1α were lower than normal value except hypotensive/ oiguric stage, GFR and ERPF strikingly decreased until polyuric or recovery stages.These results suggest that the imbalance of humoral factors might be an important factor responsible for visceral ischemia and acute renal failure, and that the antagonists of vasoconstrictors might be beneficial to circulatory recovery.

关 键 词：肾综合征出血热 体液因子 肾血液动力学 

分 类 号：R512.802[医药卫生—内科学]