血透患者血浆皮质醇促肾上腺皮质激素及心钠素改变和意义  

SERUM LEVELS OF CORTISOL AND ADRENOCORTICOTROPIC HORMONE AND ATRIAL NATRIURETIC FACTOR IN HEMODIALYSIS PATIENTS

作　　者：陈晓春[1] 陈孝文[2] 李达道[2] 

机构地区：[1]武警广东总队医院一内科,广州510507 [2]广东医学院附属医院肾病研究所

出　　处：《肾脏病与透析肾移植杂志》2000年第4期348-350,共3页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的 :探讨皮质醇 (CTS)、促肾上腺皮质激素 (ACTH)与心钠素 (ANF)等在血透患者血透前后的改变及意义。　 方法 :采用放射免疫法检测了慢性肾功能衰竭 (CRF)患者血透前后血浆皮质醇 (PCTS)、促肾上腺皮质激素 (PACTH)及心钠素 (PANF)的变化。　 结果 :透析前PCTS及PACTH较低 ,分别为 173 4± 42 1μg/L及 17 5± 10 8ng/L ;而PANF为 40 6 8± 177 1ng/L ,则明显高于正常对照组 (P <0 0 1)。透析后PCTS为 2 0 0± 88μg/L ,轻微升高 (P >0 0 5 ) ;PACTH31 2± 2 2 2ng/L明显增高 (P <0 0 5 ) ;而PANF2 0 1 8± 111 7ng/L显著降低 (P <0 0 1)　 结论 :本结果支持PANF浓度是判断细胞外液容量的敏感指标。且进一步提示ANF是ACTH及CTS分泌的抑制剂。To investigate the changes and significance of plasma levels of cortisol(P CTS ),adrenocorticotropic hormone (P ACTH )and atrial natriuretic factor (P ANP )in chronic renal failure patients before and after hemodialysis. METHODOLOGY The levels of P CTS ,P ACTH and P ANF were determined with radioimmunoassay in 32 hemodialysis patients before and after a hemodialysis session. RESULTS The pre-hemodialysis P CTS (173 4±42 1 μg/L) and P ACTH (17 5±10 8 ng/L) were decreased while P ANF (406 8±177 1 ng/L)increased as compared to that of the control ( P <0 01).Post-hemodialysis,P CTS (200±88 μg/L)was not found significuatly increased ( P >0 05),while P ACTH (31 2±22 2 ng/L)was found significantly increased and P ANF (201 8±111 7 ng/L)significuatly decreased. CONCLUSION These data supported that serum concentration of P ANF is a sensitive indicator of the extracellular fluid volume status,and ANF might exert inhibitory effect on the secretion of ACTH and CTS.

关 键 词：慢性肾功能衰竭 血液透析 激素测定 治疗 

分 类 号：R459.5[医药卫生—治疗学]