一氧化氮在糖尿病性肾病中的变化及其临床意义

目的探讨一氧化氮（ＮＯ）在糖尿病性肾病（ＤＮ）中的变化规律及其与肾功能的关系。方法检测５４例糖尿病（ＤＭ）患者血清ＮＯ稳定代谢产物亚硝酸盐（ＮＯ２）与血浆内皮素（内皮缩血管肽，ＥＴ）的水平，并与２０例正常人进行比较。结果正常白蛋白尿和微量白蛋白尿糖尿病患者血清ＮＯ均显著高于正常人和大量白蛋白尿患者（Ｐ＜０．０１），ＮＯ与病程、血清尿素氮、血肌酐、血浆ＥＴ水平呈负相关，与肾小球滤过率呈正相关。结论提示ＤＭ早期高ＮＯ生成与肾小球高滤过有关，晚期低下的ＮＯ水平可能促进ＤＮ发展；ＮＯ与ＥＴ之间可能存在互相制约、动态平衡的关系，平衡紊乱与ＤＮ的发生、发展有关

Relationship between circulating nitric oxide level and renal function in diabetic patients

Objective Studying the role of nitric oxide (NO) in the pathogenesis of diabetic nephropathy (DN).Methods The circulating level of nitrite (NO 2 ) a stable metabolic product of NO, was measured in 20 normal subjects (NC group), 21 diabetic patientswithnormoalbuminuria(SDM group),17 cases of incipientDN(IDN group)and16 cases of overt DN (ODN group). Plasma endothelin (ET) level was determined simultaneously. Results NO 2 concentration was markedly elevated in SDM group and IDN group than inNCandODN group (P<0.01). There was significantnegativecorrelationbetween NO 2 level and duration, blood pressure, blood urea nitrogen, serum creatine, plasma ET level and a significant positive correlation between NO 2 level and glomerular filtration rate. Conclusion ElevatedNOisrelatedto renal hyperfiltrationinearlystageof diabetes mellitus (DM) and the decreased NO level in advanced DM may promote the development of DN. The disturbance of the equilibrium between ET and NO may be correlated with DN.