Ozdemir S, Saatçi U, Beşbaş N, Bakkaloglu A, Ozen S, Koray Z
Department of Paediatric Nephrology, Hacettepe University, Ankara, Turkey.
Pediatr Nephrol. 1992 Nov;6(6):519-22. doi: 10.1007/BF00866489.
Plasma levels of atrial natriuretic peptide (ANP) and of endothelin (ET) were significantly elevated (87.7 +/- 13.9 pg/ml and 79.7 +/- 10.8pg/ml, respectively) during the acute phase of acute poststreptococcal glomerulonephritis (APSGN). Plasma renin levels were normal, fractional excretion of sodium (FENa) was 0.5 +/- 0.1% and creatinine clearance (CCr) averaged 82.2 +/- 18.3 ml/min per 1.73 m2. In the recovery phase of the disease (n = 12), levels of ANP (23.6 +/- 6.7 pg/ml) and ET (43.1 +/- 2.4 pg/ml) fell and were not significantly different from those measured in 11 control subjects. FENa increased to 1.3 +/- 0.1% and CCr to 113.5 +/- 12.1 ml/min per 1.73 m2 (all values mean +/- standard error). ANP did not correlate with PRA, blood pressure, CCr or FENa. There was an inverse relationship between the ET level and FENa in the acute phase of the disease (r = 0.489, P < 0.05), but no significant correlation between ET and blood pressure, PRA, CCr or ANP was found. We suggest that, despite the sodium retention, the increased ANP level in APSGN indicates unresponsiveness of the kidneys to ANP; the increased ET levels may contribute to this.
在急性链球菌感染后肾小球肾炎（APSGN）的急性期，血浆心房利钠肽（ANP）和内皮素（ET）水平显著升高（分别为87.7±13.9 pg/ml和79.7±10.8 pg/ml）。血浆肾素水平正常，钠分数排泄率（FENa）为0.5±0.1%，肌酐清除率（CCr）平均为每1.73 m² 82.2±18.3 ml/min。在疾病的恢复期（n = 12），ANP（23.6±6.7 pg/ml）和ET（43.1±2.4 pg/ml）水平下降，与11名对照受试者测得的水平无显著差异。FENa升至1.3±0.1%，CCr升至每1.73 m² 113.5±12.1 ml/min（所有数值均为平均值±标准误）。ANP与血浆肾素活性（PRA）、血压、CCr或FENa均无相关性。在疾病急性期，ET水平与FENa呈负相关（r = 0.489，P < 0.05），但未发现ET与血压、PRA、CCr或ANP之间存在显著相关性。我们认为，尽管存在钠潴留，但APSGN中ANP水平升高表明肾脏对ANP无反应；ET水平升高可能对此有影响。
