Lin S Y, Chen L Q, Wang Y H, Zhou J H
Nephrology Research Laboratory, Hua Shan Hospital, Shanghai Medical University.
Chin Med J (Engl). 1991 Apr;104(4):288-91.
To study the mechanism of plasma endothelin (pET) increment in chronic renal failure (CRF) patients, we investigated 20 CRF cases given hemoultrafiltration for 90 min followed by hemodialysis and 12 given hemodialysis only to examine the effect on ET. The results revealed that 90-min ultrafiltration with 2 500ml fluid extraction significantly decreased plasma ET (1 132 +/- 793--753 +/- 702 pg/ml, P less than 0.05), while hemodialysis without water extraction for the same period of time resulted in no significant change (1 195 +/- 891--1 011 +/- 654pg/ml, P greater than 0.05). BUN in the ultrafiltration group showed no marked changes (102 +/- 11.4--83.5 +/- 119 mg/dl), but the hemodialysis group presented a significant decrease (97 +/- 12--63 +/- 7 mg/dl, P less than 0.05), showing that the ET fall had no significant relevance to the metabolic products extracted. In 120 min following hemodialysis, ET levels in both groups decreased by different amounts. MAP decreased in both groups throughout the procedure period. Therefore, it is suggested that decreased extracellular volume via ultrafiltration can lead to lowering of ET levels, showing that extracellular volume may influence the ET level.
为研究慢性肾功能衰竭（CRF）患者血浆内皮素（pET）升高的机制，我们对20例CRF患者进行了研究，这些患者先进行90分钟血液超滤，随后进行血液透析，另选12例仅接受血液透析的患者作为对照，以观察对内皮素的影响。结果显示，超滤2500ml液体90分钟可使血浆内皮素显著降低（从1132±793pg/ml降至753±702pg/ml，P＜0.05），而同期未进行脱水的血液透析则无显著变化（从1195±891pg/ml降至1011±654pg/ml，P＞0.05）。超滤组尿素氮无明显变化（从102±11.4mg/dl降至83.5±119mg/dl），而血液透析组则显著降低（从97±12mg/dl降至63±7mg/dl，P＜0.05），表明内皮素下降与清除的代谢产物无明显相关性。血液透析后120分钟内，两组内皮素水平均有不同程度下降。整个过程中两组平均动脉压（MAP）均下降。因此，提示超滤导致细胞外液量减少可使内皮素水平降低，表明细胞外液量可能影响内皮素水平。
