【摘要】 目的探讨内皮素-1(ET-1)、一氧化氮(NO)在糖尿病肾病(DN)发病机制中的作用。方法用RIA测定70例2型DM患者和24例正常对照组血浆ET-1、尿白蛋白(Alb),用硝酸还原酶法测定其血清NO。结果随DN的发展,血浆ET-1水平逐渐增高,血清NO水平逐渐降低。在糖尿病(DM)患者中血浆ET-1与血清NO成负相关(r=-0·47,P<0·001)。结论2型DM患者血浆ET-1水平与DN的进展密切相关。血清NO水平与早期肾小球高滤过的形成有关。更多还原

【Abstract】 Objective To evaluate the role of NO and ET-1 in the pathogenesis of diabetic nephropathy (DN). Methods 70 patients with type 2 diabetes mellitus (DM)were divided into three groups according to the level of albumin excreted in urine by patients with diabetes mellitus in 24 hours. Group I consisted of 38 cases without nephropathy (DMⅠ, normoalbuminuria <30mg/24h), Group II consisted of 20 cases with incipient nephropathy (DMⅡ, microalbuminuria 30～300mg/24h) and Group III consisted of 12 cases with clinical nephropathy (DM Ⅲ, macroalbuminuria >300mg/24h). Normal control (NC) consisted of 24 cases. Plasma ET-1 and urinary albumin were measured by radioimmunoassay. Serum NO was measured by colorimetric assay. Results The levels of plasma ET-1 was increased along with the development of DN, while the level of serum NO levels was decreased. Negative correlation between the level of plasma ET-1 and the level of serum NO (r=-0.47, P<0.001) was observed in patients with diabetes mellitus. Conclusion Plasma ET-1 is closely associated with the development and progression of DN. The level of serum NO will be increased in patients with diabetes mellitus at phasesⅠand Ⅱ and progressively declined in those at phase Ⅲ. Enhanced NO synthesis early in diabetes could cause preferential dilation of afferent arterioles, which ultimately induces glomerular enlargement and glomerular hyperfiltration. NO suppresses mesangial cell proliferation and ECM formation. Decreased NO production later in diabetes may offset these protective roles of NO.更多还原