【摘要】 目的　探讨阻塞性黄疸时肾脏自分泌内皮素 (ET)的变化及其与肾功能损害的关系。方法　结扎胆总管(BDL)制备阻塞性黄疸大鼠模型 ,作为实验组 ,对照组鼠仅行假手术。分别于术后 5、1 0及 1 5d ,两组各取 1 0只大鼠检测其肾脏对氨基马尿酸清除率 (CPAH)、菊粉清除率 (CIN)和钠排泄分数 (FENa+) ,并用鲎试剂法测定血浆内毒素 (EX)水平 ,放射免疫法测定肾动、静脉血浆及肾组织中ET 1含量。结果　①实验组术后 5d仅FENa+明显高于对照组 (P<0 .0 1 ) ,术后 1 0d起 ,CPAH、CIN及FENa+呈进行性下降 ,术后 1 5dFENa+已较对照组低 ,与对照组比较差异有显著性 (P<0 .0 1 ) ;②实验组术后血浆EX水平呈进行性升高 ,与对照组比较差异有显著性 (P<0 .0 1 ) ;③实验组术后肾动脉血浆ET 1水平呈持续性降低 ,而肾静脉血浆及肾组织中ET 1含量呈持续性升高 ,与对照组比较差异有显著性 (P<0 .0 1 ) ;④血浆EX水平与肾组织ET 1含量呈正相关 (r =0 .762 4 ,P<0 .0 1 ) ,肾组织ET 1含量与CPAH和CIN呈负相关 (r=- 0 .883 2 ,P<0 .0 1 ;r =- 0 .945 2 ,P<0 .0 1 )、与FENa+呈正相关 (r=0 .873 4 ,P<0 .0 1 )。结论　内毒素血症及其诱导的肾内ET分泌增加在阻塞性黄疸所致大鼠肾损害中可能具有重要作用更多还原

【Abstract】 Objective To investigate the change of renal endothelin (ET) excretion and its relation to renal dysfunctions in obstructive jaundice.Methods Sixty male Wistar rats were randomized into two groups, the common bile ducts were ligated to establish the model of obstructive jaundice in experimental group, and only sham operation was done in control group. Ten rats were taken from each group at 5, 10 and 15 days respectively after operation, renal functions were evaluated by p aminohippuric acid clearance (C PAH ), inulin clearance (C IN ) and fractional sodium excretion (FE Na + ); furthermore, plasma endotoxin (EX) level was determined, and ET 1 contents in renal arterial plasma, renal venous plasma and renal tissue were detected. Results Only FE Na + was significantly increased at the 5th day in experimental group; since the 10th day, all the three renal functional parameters gradually decreased, and FE Na + was significantly lower than that in control group at 15th day ( P <0.01 vs control). ②The plasma EX sustained at significantly higher levels after operation in experimental group ( P <0.01 vs control). ③The renal arterial plasma ET 1 was significantly decreased, while the contents in renal venous plasma and renal tissue were significantly increased after operation in experimental group ( P <0.01 vs control). ④There were positive correlation between plasma EX and renal ET 1 content, negative correlation between renal ET 1 content and C PAH /C IN , and positive correlation between renal ET 1 content and FE Na + ( P <0.01).Conclusion The increased excretion of renal ET stimulated by endotoxemia may play an important role in the renal dysfunctions in obstructive jaundice.更多还原