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探讨成人原发性肾病综合征(NS)血容量与肾素、醛固酮及心钠素的关系。方法 应用~(113)mInCl标记转铁蛋白稀释法测定血容量,放免法测定血浆激素水平。对水肿期NS28例、正常26例及其中NS缓解期随访18例进行检测。结果 (1)水肿期NS血容量与正常组无差别,血浆肾素活性(PRA)、血管紧张素Ⅱ(ATⅡ)、醛固酮(Ald)、心钠素(ANP)水平均较正常组高,白蛋白、各激素水平与血容量无显著相关;(2)缓解期与水肿期比较,总的血容量无差异,Ald、ANP显著降低,PRA、ATⅡ则无明显差异;(3)Ald与24小时尿排钠(UNaV)显著负相关。结论 Ald和ANP是NS钠排泄的主要调节因子。
To investigate the relationship between blood volume of renin, aldosterone and atrial natriuretic peptide in adult patients with primary nephrotic syndrome (NS). Methods The blood volume was measured by ~ (113) mInCl labeled transferrin dilution method, and the level of plasma hormone was determined by radioimmunoassay. NS edema in 28 cases, normal 26 cases and NS in 18 cases of follow-up were tested. Results (1) NS blood volume in edematous period had no difference with normal group. The levels of plasma renin activity (PRA), angiotensin Ⅱ (ATⅡ), aldosterone (Ald) and atrial natriuretic peptide (ANP) (2) There was no difference in total blood volume between the remission period and the edema period, Ald, ANP significantly reduced, PRA, AT Ⅱ no significant difference; (3) Ald and 24 hours Urinary sodium (UNaV) was significantly negatively correlated. Conclusion Ald and ANP are the major regulators of sodium excretion in NS.