肾上腺髓质素对肾小管间质损伤的保护作用

为探讨肾上腺髓质素（ADM）在肾小管间质病变中的作用，采用放射免疫法测定了26例合并小管间质病变的原发性肾小球肾炎病人血交ADM,在培养的人近曲肾小管上皮细胞系（HK－2）观察了ADM对胶原合成和分泌的影响。结果表明，小管间质轻度病变组和重度病变组血浆ADM水平较对照组分别增加了1．2倍和2．2倍（P＜0．01），其中间质重度病变组较轻度病变组血浆ADM水平高出0．5倍（P＜0．01）；ADM对静止的HK－2细胞胶质合成和分泌无明显影响，但能够控制TGF－β1刺激的胶原合成和分泌（P＜0．01）。提示合并小管间质病变的原发性肾小球肾炎病人血浆ADM水平升高，可能为一种代偿性的保护作用。

Protective effect of adrenomedullin on human renal tubulointerstitial lesion

In this study,we investigated the effect of adrenomedullin(ADM) on renal tubulointerstitial lesion.Plasma ADM concentration was measured in 26 glomerulonephritis patients with tubulointerstitial lesion by radioimmunoassay,and collagen synthesis and secretion of HK-2 cells were determined by 3H-proline incorporation and radioactivity in medium.As compared with normal subjects,plasma ADM was increased by 120% (P＜0.01) in patients with mild tubulointerstitial lesion，and by 220% (P＜0.01) in those with severe lesion,which was more prominent than in mild lesion (P＜0.01); ADM had no effect on resting HK-2 cells,but could inhibit the TGF-β1 induced collagen synthesis and secretion.This study suggested that besides diuretic and natriuretic actions,ADM can also inhibit renal tubular cells collagen synthesis and secretion stimulated by TGF-β1.Plasma ADM increase in glomerulonephritis patients with tubulointerstitial lesion may be a compansative protection.