Nishimura M, Takahashi H, Yoshimura M
Department of Clinical and Laboratory Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamikyo-ku, Kyoto, Japan.
Acta Physiol Scand. 2000 Jan;168(1):181-6. doi: 10.1046/j.1365-201x.2000.00662.x.
To investigate the possible involvement of nitric oxide (NO) in haemodialysis hypotension, we measured plasma concentrations of nitrate anion (NO3-), a metabolite of NO, in 114 patients undergoing maintenance haemodialysis. Mean plasma NO3- concentrations before dialysis were greater in subjects with lower blood pressure (155 +/- 16 micromol L-1) than in those with middle (117 +/- 8 micromol L-1) or higher blood pressure (105 +/- 12 micromol L-1) before dialysis. Further, mean plasma NO3- concentrations before dialysis were greater in subjects with lower blood pressure (186 +/- 13 micromol L-1) than in those with middle (112 +/- 7 micromol L-1) or higher blood pressure (64 +/- 11 micromol L-1) after dialysis. Plasma NO3- concentrations before dialysis were inversely correlated with mean blood pressure before dialysis (r=0.318, P=0.0006), and showed a strong inverse correlation with mean blood pressure after dialysis (r=0.608, P=0.0001). In the selected participants who had equal range of mean blood pressure before dialysis, mean plasma NO3- concentrations were greater in subjects with severe hypotension during dialysis (180 +/- 14 micromol L-1) than in those with mild hypotension (99 +/- 11 micromol L-1) or without hypotension (53 +/- 12 micromol L-1); plasma NO3- concentrations before dialysis were inversely correlated with changes in mean blood pressure during dialysis and mean blood pressure after dialysis. Results indicate that enhanced NO production may be involved in acute hypotension during dialysis, and suggest the possible involvement of NO in the pathogenesis of chronic hypotension associated with maintenance haemodialysis.
为研究一氧化氮（NO）在血液透析低血压中的可能作用，我们测定了114例维持性血液透析患者血浆中NO的代谢产物硝酸根阴离子（NO3-）的浓度。透析前血压较低的患者血浆NO3-平均浓度（155±16μmol/L）高于透析前血压处于中等水平（117±8μmol/L）或较高水平（105±12μmol/L）的患者。此外，透析后血压较低的患者血浆NO3-平均浓度（186±13μmol/L）高于透析后血压处于中等水平（112±7μmol/L）或较高水平（64±11μmol/L）的患者。透析前血浆NO3-浓度与透析前平均血压呈负相关（r=0.318，P=0.0006），且与透析后平均血压呈强负相关（r=0.608，P=0.0001）。在透析前平均血压范围相同的入选参与者中，透析期间发生严重低血压的患者血浆NO3-平均浓度（180±14μmol/L）高于发生轻度低血压的患者（99±11μmol/L）或未发生低血压的患者（53±12μmol/L）；透析前血浆NO3-浓度与透析期间平均血压变化及透析后平均血压呈负相关。结果表明，NO生成增加可能与透析期间的急性低血压有关，并提示NO可能参与了维持性血液透析相关慢性低血压的发病机制。
