肾动脉狭窄患者治疗前后血浆肾上腺髓质素水平的变化  

Changes of serum adrenomedullin concentration after treatment in patients with renal artery stenosis

作　　者：胡威[1] 张孝斌[2] 

机构地区：[1]南华大学附属南华医院泌尿外科,湖南衡阳421002 [2]武汉大学人民医院泌尿外科,湖北武汉430060

出　　处：《中国现代医学杂志》2012年第17期54-57,共4页China Journal of Modern Medicine

摘　　要：目的探讨肾动脉狭窄患者在卡托普利抗高血压及介入支架治疗前后血浆肾上腺髓质素(ADM)水平的变化。方法选取50例健康体检者作为对照组,66例肾动脉狭窄患者的血压按1999年WHO/ISH第4次修订的高血压诊断标准分为1、2、3级,36例肾动脉狭窄引起的继发性高血压患者接受了卡托普利治疗,其中27例治疗后血压降至正常,9例3级高血压患者治疗后血压降至2级,经接受介入支架治疗后血压降至正常;另30例接受了介入支架治疗,治疗后血压均降至正常,用放射免疫法测定对照组及各治疗组治疗前后血浆ADM浓度。结果肾动脉狭窄患者血浆ADM浓度明显高于对照组,并且随着血压级别的升高,血浆ADM浓度也随之明显升高,在卡托普利及介入支架治疗后,血压及血浆ADM浓度明显下降。结论肾动脉狭窄患者血浆ADM浓度明显升高,ADM在肾动脉狭窄引起的继发性高血压的病理生理过程中起一定作用,并且在卡托普利抗高血压及介入支架治疗后血压及ADM浓度明显下降,说明这两种治疗方法在肾动脉狭窄的治疗中及ADM对血压的调节和肾功能的保护有重要的意义。【Objective】 To study the changes of serum adrenomedullin concentration after treatment of Captopril and intervention stenting in patients with renal artery stenosis.【Methods】 The adrenomedullin concentration was measured by radioimmunoassay,which was sampled from 50 healthy controls and 66 patients with renal artery stenosis who were divided into two groups.One group took Captopril and the other group took intervention stenting.【Results】 The adrenomedullin concentration of patients with renal artery stenosis was significantly higher than that of controls and it would be higher with the blood pressure up.But it would be lower after treatment of Captopril and intervention stenting and it was the same to blood pressure.【Conclusions】 The adrenomedullin concentration of patients with renal artery stenosis was obviously higher.Adrenomedullin may play an important role in the pathophysiological course of secondary hypertension caused by renal artery stenosis.Blood pressure and adrenomedullin concentration were lower after treatment of Captopril and intervention stenting.The two means have some significance for treatment of renal artery stenosis and in adjustment of blood pressure and protection of renal function.

关 键 词：肾动脉狭窄 肾上腺髓质素 高血压 卡托普利 介入支架 

分 类 号：R692.16[医药卫生—泌尿科学] R459.9[医药卫生—外科学]