Jensen J D, Eiskjaer H, Madsen B, Egeblad M, Nielsen C B, Pedersen E B
Department of Medicine and Nephrology C, Skejby Hospital, Denmark.
Scand J Clin Lab Invest. 1993 Dec;53(8):859-65. doi: 10.3109/00365519309086499.
Twenty-nine patients with unilateral renal artery stenosis or occlusion were investigated. The veno-arterial gradient (VA-gradient) of erythropoietin (EPO), haemoglobin oxygen saturation and plasma renin activity (PRA) was determined separately in each kidney before and 1 h after angiotensin converting enzyme inhibition (ACE-inhibition). The VA-gradient of EPO and of hemoglobin oxygen saturation were the same in the affected and unaffected kidney during basal conditions. During ACE-inhibition the VA-gradient of EPO disappeared on the affected side but not on the unaffected side. A fall in s-EPO after ACE inhibition was demonstrated in the renal vein on the affected side (-1.4 U l-1, p < 0.01), in the contralateral vein (-0.8 U l-1, p < 0.01) and in the aorta (-0.6 U l-1, p < 0.01). The O2-gradients were reduced on both sides after captopril, from 10.8-7.5% (p < 0.04) on the affected side and from 10.8-9.0% (p < 0.04) on the contralateral. It is suggested that the stimulated renin-angiotensin system may be important for EPO production in the affected kidney in unilateral renal disease.
对29例单侧肾动脉狭窄或闭塞患者进行了研究。在血管紧张素转换酶抑制（ACE抑制）前后1小时，分别测定每个肾脏中促红细胞生成素（EPO）的静脉-动脉梯度（VA梯度）、血红蛋白氧饱和度和血浆肾素活性（PRA）。在基础状态下，患侧和未患侧肾脏中EPO和血红蛋白氧饱和度的VA梯度相同。在ACE抑制期间，患侧EPO的VA梯度消失，而未患侧则未消失。ACE抑制后，患侧肾静脉中s-EPO下降（-1.4 U l-1，p<0.01），对侧静脉中（-0.8 U l-1，p<0.01）和主动脉中（-0.6 U l-1，p<0.01）。卡托普利治疗后，两侧的O2梯度均降低，患侧从10.8%降至7.5%（p<0.04），对侧从10.8%降至9.0%（p<0.04）。提示在单侧肾脏疾病中，受刺激的肾素-血管紧张素系统可能对患侧肾脏中EPO的产生起重要作用。
