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目的了解梗阻性黄疸动物体内血浆内皮素（ＥＴ）含量变化情况，探讨ＥＴ在梗阻性黄疸时肾脏损害机制中的作用。方法以犬为实验对象，１０条犬作胆总管结扎为实验组；１０条犬作假手术为对照组。用特异性放免法检测术前及术后１、４、７天血浆ＥＴ含量，同时测定血浆内毒素水平，血生化指标及肾功能情况，并于术后７天取肾组织行电镜观察。结果实验组术后ＥＴ含量持续升高伴血浆内毒素水平升高，血清总胆红素升高，肌酐清除率下降，肾小球系膜细胞显著增生。ＥＴ含量升高程度与肌酐清除率下降程度及肾病理改变相平行。结论梗阻性黄疸时血浆ＥＴ含量升高，且与血浆内毒素水平、血清总胆红素水平相关；ＥＴ升高后导致肾小球系膜细胞增生，可能是梗阻性黄疸肾脏损害的发病机制之一。
Objective To investigate the changes of plasma endothelin (ET) levels in obstructive jaundice animals and to explore the role of ET in the mechanism of renal damage in obstructive jaundice. Methods Dogs were used as experimental subjects, 10 dogs were treated by common bile duct ligation, and 10 dogs were sham operated as control group. The levels of plasma ET, preoperative and postoperative 1, 4 and 7 days were measured by specific radioimmunoassay. Plasma endotoxin levels, blood biochemical parameters and renal function were also measured. The kidneys were examined by electron microscopy 7 days after operation. Results The content of ET in the experimental group continued to increase with the increase of plasma endotoxin level, the increase of serum total bilirubin, the decrease of creatinine clearance and the significant proliferation of mesangial cells. The increase of ET content was in parallel with the decrease of creatinine clearance rate and renal pathological changes. Conclusions The content of ET in the patients with obstructive jaundice increases, and is related to the levels of plasma endotoxin and serum total bilirubin. The increase of ET leads to the proliferation of mesangial cells, which may be the pathogenesis of obstructive jaundice kidney damage one.