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目的观察肾上腺髓质素(ADM)及内皮素(ET)在原发性高血压肾功能损害患者血浆浓度的改变,探讨ADM及ET在高血压肾功能损害时的意义。方法用特异性的放射免疫法(RIA)测定18例健康志愿者及52例原发性高血压患者[36例Ⅰ期高血压(Ⅰ期组),16例高血压合并肾功能损害(肾损组)]。血浆ADM及ET的浓度。结果Ⅰ期组血浆ADM和ET水平较正常组显著升高,而肾损组血浆ADM、ET水平较Ⅰ期组又显著升高(P<0.01)。高血压时血浆ADM、ET水平与BUN Cr水平呈显著正相关,与肾小球滤过率(GFR)呈显著负相关。结论血浆ADM、ET水平与肾功能关系密切。ADM可能是为抵消ET等缩血管物质在高血压时的过度分泌而代偿性地合成、释放增多,对肾脏起保护作用。
Objective To investigate the changes of plasma concentrations of adrenomedullin (ADM) and endothelin (ET) in patients with essential hypertension with impaired renal function and to explore the significance of ADM and ET in the pathogenesis of hypertensive renal dysfunction. Methods Twenty-eight healthy volunteers and 52 patients with essential hypertension were measured by specific radioimmunoassay (RIA) [36 patients with stage I hypertension (group I) and 16 with hypertension (renal impairment group)]. Plasma ADM and ET concentrations. Results The level of plasma ADM and ET in stage Ⅰ group was significantly higher than that in normal group, while the level of plasma ADM and ET in renal injury group was significantly higher than that in stage Ⅰ (P <0.01). There was a significant positive correlation between plasma ADM and ET levels and BUN Cr level in hypertension and a significant negative correlation with glomerular filtration rate (GFR). Conclusion Plasma ADM, ET levels are closely related to renal function. ADM may be to offset ET and other vasoconstrictors in the excessive secretion of hypertension and compensatory synthesis, increased release of the kidney play a protective effect.