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目的:比较狼疮性肾炎(LN)肾功能衰竭患者血液透析前后血浆内皮素(ET)、一氧化氮(NO)及心钠素(ANP)含量变化并分析其临床意义。方法:32例LN肾功能衰竭患者采用硝酸还原法检测NO,放射免疫分析ET、ANP含量。结果:LN肾功能衰竭组NO、ET、ANP浓度明显高于正常对照组(P<0.05),且ET、NO及ANP水平升高的程度与肾功能损害的严重性呈正比;透析后NO和ANP显著下降(P<0.05),ET透析后有下降趋势,但与透析前相比无统计学意义(P>0.05)。结论:血管活性因子ET、NO及ANP参与了LN发病并加重其病情,血浆ET、NO及ANP浓度可作为判断LN患者肾功能损害程度的指标。血液透析后可以使LN肾功能衰竭组患者血浆NO及ANP含量明显降低。
Objective: To compare the changes of plasma endothelin (ET), nitric oxide (NO) and atrial natriuretic peptide (AN) before and after hemodialysis in patients with lupus nephritis (LN) with renal failure and to analyze their clinical significance. Methods: Nitric acid reduction was used to detect NO and radioimmunoassay (ET) and ANP in 32 LN patients with renal failure. Results: The levels of NO, ET and ANP in LN renal failure group were significantly higher than those in normal control group (P <0.05), and the levels of ET, NO and ANP were positively correlated with the severity of renal dysfunction; ANP decreased significantly (P <0.05), ET decreased after dialysis, but there was no significant difference compared with before dialysis (P> 0.05). Conclusions: Vasoactive factors ET, NO and ANP are involved in the pathogenesis and aggravation of LN. The concentrations of plasma ET, NO and ANP may be used as indexes to judge the degree of renal dysfunction in patients with LN. After hemodialysis can make LN renal failure patients plasma NO and ANP levels were significantly lower.