老年原发性肾病综合征患者血、尿内皮素的变化  

Changes of blood and urine endothelin levels in the elderly patients with primary nephritic syndrome

作　　者：夏成云[1] 周京国[1] 邓隆银[1] 孙跃军[2] 

机构地区：[1]川北医学院附属医院内科,四川省南充市637000 [2]川北医学院附属医院核医学科,四川省南充市637000

出　　处：《中华老年医学杂志》2003年第4期211-213,共3页Chinese Journal of Geriatrics

摘　　要：目的　探讨血、尿内皮素在老年原发性肾病综合征 (PNS)患者中的变化及临床意义。　方法　采用放射免疫法对健康老年、非老年人 (对照组 )和不同病期老年、非老年PNS患者的血、尿内皮素含量进行测定 ,并对老年PNS患者血、尿内皮素水平与血肌酐 (Scr)、内生肌酐清除率 (Ccr)、2 4h尿蛋白定量、尿视黄醇结合蛋白 (uRBP)等指标进行分析。　结果　老年PNS活动期组血、尿内皮素含量分别为 (2 2 9± 81)ng/L、(14 3± 5 8)ng/ 2 4h ,显著高于缓解期组的 (6 0± 11)ng/L、(5 3± 13)ng/2 4h及老年对照组的 (5 3± 9)ng/L、(5 0± 14 )ng/ 2 4h(均为P <0 0 1) ,而缓解期组与老年对照组比较差异无显著性。老年PNS活动期组、缓解期组血、尿内皮素含量与非老年PNS组间差异无显著性。老年PNS活动期尿内皮素水平与Scr、2 4h尿蛋白定量、uRBP呈正相关 (r=0 4 7～ 0 6 7,均为P<0 0 1) ,与Ccr、血浆白蛋白呈显著负相关 (r =- 0 5 6 ,- 0 4 7,P <0 0 1) ,老年PNS患者活动期血浆内皮素水平与Scr、血浆白蛋白、Ccr、2 4h尿蛋白定量、uRBP无相关性。　结论　内皮素参与了老年人PNS的发病过程 。Objective To investigate the changes of blood and urine endothelin levels in the aged patients with primary nephrotic syndrome(PNS) and their clinical significance. Methods The levels of blood and urine endothelin were measured by radioimmunoassay at different stages(active and alleviated stages) in 40 elderly and 40 non elderly patients with PNS and 40 elderly healthy controls(control group). The levels of endothelin in blood and urine of the aged patients with PNS, and serum creatinine(Scr), endogenous creatinine clearance rate(Ccr), 24 hour urinary protein and urinary retinal binding protein(uRBP) were determined. Results The contents of endothelin in blood and urine of the aged PNS patients in the active stage were (229±81) ng/L and (143±58)ng/24 h,which were apparently higher than those in the alleviated stage 〔(60±11) ng/L, (53±13)ng/24 h〕 and the healthy control group〔(53±9) ng/L, (50±14 ng)/24 h, P <0 01〕. But there was no significant difference between the alleviated stage group and normal healthy control group in the endothelin level. In the same period, the contents of blood and urine endothelin of the aged PNS active stage and alleviated stage showed no obvious difference as compared with the non aged PNS. The level of urine endothelin in active stage of the aged PNS was positively correlated with Scr, 24 hour urinary protein and uRBP( r =0 48-0 67, P <0 01), and showed negative correlation with Ccr and plasma albumin( r =-0 56,-0 47, P <0 01). The level of blood endothelin in the active stage of the aged PNS was not positively related to Scr, Ccr, 24 hour urinary protein, plasma albumin,uRBP ( r =-0 23, -0 21, P >0 05). Conclusions Endothelin may be involved in the pathogenesis of the aged PNS. The increased urine endothelin level may be an important factor in glomerulus and tubular damage in the elderly PNS patients.

关 键 词：原发性肾病综合征 老年人 内皮素 血肌酐 内生肌酐清除率 尿蛋白 尿视黄醇结合蛋白 

分 类 号：R692[医药卫生—泌尿科学]