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目的检测系统性硬化症(SSc)伴/不伴临床肾损害的患者血清、尿内皮素-1(ET-1)水平有无差别,及其在依那普利治疗后的变化,以探讨ET-1在SSc肾损害中的作用。方法放射免疫法分析11例伴有临床肾损害表现的SSc患者(肾病组)血清、尿ET-1水平,并与23例不伴有临床肾损害表现的SSc患者(无肾病组)、15名健康人(健康对照组)相对比。并观察肾病组患者在依那普利治疗2周后血清、尿ET-1水平的变化。结果肾病组与无肾病组SSc患者血清、尿ET-1水平均高于健康对照组(P＜0．05)．但前两组患者血清ET-1水平差异无统计学意义(P＞0．05)。肾病组患者尿ET-1较无肾病组及健康对照组明显增加(P＜0．05),且肾病组患者尿ET-1的增加与该组患者内生肌酐清除率的下降呈显著负相关(r=-0．7737,P＜0．05)。肾病组患者在依那普利治疗2周后,血清ET-1无明显变化,尿ET-1明显下降(P＜0．05)。结论SSc患者肾脏中ET-1生成增加,伴有临床肾损害者尤其明显。肾脏ET-1的增加可能促进了SSc患者肾功能损害的发生、发展。使用依那普利治疗可明显减少肾脏ET-1的产生。
Objective To detect the serum and urinary ET-1 levels in patients with systemic sclerosis (SSc) with / without clinical renal impairment, and to explore the changes of ET-1 levels after enalapril treatment -1 in SSc renal damage. Methods Serum and urinary levels of ET-1 in 11 patients with SSc (nephropathy group) with clinical renal impairment were analyzed by radioimmunoassay and were compared with 23 patients with SSc who did not show clinical renal impairment (no nephropathy group), 15 Healthy people (healthy control group) relative ratio. The levels of ET-1 in serum and urine of patients with nephropathy were observed after enalapril treatment for 2 weeks. Results Serum and urinary ET-1 levels in patients with nephropathy and without nephropathy were significantly higher than those in healthy controls (P <0.05). However, there was no significant difference in serum ET-1 levels between the two groups (P> 0.05). Urine ET-1 in nephropathy group was significantly higher than that in nephropathy group and healthy control group (P <0.05), and the increase of urinary ET-1 in nephropathy group was negatively correlated with the decrease of endogenous creatinine clearance rate (r = -0.7737, P <0.05). In the nephrotic group, serum ET-1 did not change significantly after 2 weeks of enalapril treatment, urinary ET-1 level decreased significantly (P <0.05). Conclusions ET-1 production is increased in the kidneys of patients with SSc, especially with clinical renal impairment. Increased renal ET-1 may promote the occurrence and development of renal impairment in patients with SSc. Treatment with enalapril significantly reduced ET-1 production in the kidney.