Kubo A, Iwano M, Minamino N, Sato H, Nishino T, Hirata E, Akai Y, Shiiki H, Kitamura K, Kangawa K, Matsuo H, Dohi K
1st Department of Internal Medicine, Nara Medical University, Japan.
Nephron. 1998;78(4):389-94. doi: 10.1159/000044966.
In this study, we measured plasma and urinary adrenomedullin (AM) concentrations in 47 patients with IgA nephropathy. Controls were 39 healthy volunteers. Plasma and urinary AM values were measured by specific radioimmunoassay. The plasma AM concentrations were higher, and the urinary AM levels were lower in patients with IgA nephropathy than in healthy volunteers. Plasma AM concentrations showed a positive correlation with serum creatinine and blood urea nitrogen, whereas urinary AM levels correlated negatively with serum creatinine and blood urea nitrogen. The plasma AM concentrations showed a positive correlation with fractional excretions of sodium and potassium. Renal biopsy specimens of patients without renal failure were scored for activity (percentage of glomeruli demonstrating cellular crescent formation, degree of mesangial proliferation and interstitial infiltration; total score = 9). Urinary AM levels were shown to be lower in the group with a high activity (score 3-9) as compared with the group with a low activity (score 0-2) based on renal biopsy. Thus, urinary levels of AM are affected by the degree of the activity in IgA nephropathy, and AM may participate in the pathophysiology of IgA nephropathy.
在本研究中，我们测定了47例IgA肾病患者的血浆和尿肾上腺髓质素（AM）浓度。对照组为39名健康志愿者。采用特异性放射免疫分析法测定血浆和尿AM值。IgA肾病患者的血浆AM浓度较高，而尿AM水平低于健康志愿者。血浆AM浓度与血清肌酐和血尿素氮呈正相关，而尿AM水平与血清肌酐和血尿素氮呈负相关。血浆AM浓度与钠和钾的排泄分数呈正相关。对无肾衰竭患者的肾活检标本进行活性评分（显示细胞新月体形成的肾小球百分比、系膜增生程度和间质浸润程度；总分=9）。根据肾活检结果，高活性组（评分3 - 9）的尿AM水平低于低活性组（评分0 - 2）。因此，IgA肾病中尿AM水平受疾病活性程度的影响，且AM可能参与了IgA肾病的病理生理过程。
