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目的 :探讨内皮素 (ET)系统与糖尿病 (DM )造影剂肾病发生的关系。方法 :建立单侧肾切除糖尿病肾病模型 ,观察静脉注入 76 %泛影葡胺 (10mg/kg)后血肌酐、肌酐清除率和血浆ET - 1的变化情况 ,以及肾脏ET- 1、ET受体A、B(ETR -A、ETR -B)的表达情况。结果 :单侧肾切除糖尿病大鼠喂养 8周时 ,血肌酐较正常大鼠升高 ,肌酐清除率、血浆内皮素 - 1浓度较正常大鼠明显降低 ,有显著性差异 (P <0 .0 5 ) ;糖尿病大鼠禁水2 4h后注射 76 %泛影葡胺 ,血肌酐升高 ,内生肌酐清除率下降 ,与糖尿病对照组有显著性差异 (P <0 .0 5 ) ,血浆ET - 1浓度较糖尿病对照组有所升高 ,但无显著性差异。DM对照组肾小管间质ET - 1、ETR -A、ETR -B表达较正常对照组显著增加 ,注射 76 %泛影胺后表达增加更明显。结论 :糖尿病肾功能不全时 ,造影剂肾病的发生与内皮素系统特别是肾脏局部内皮素系统可能有关。
Objective: To investigate the relationship between endothelin (ET) system and diabetic nephropathy. Methods: The model of diabetic nephropathy was established by unilateral nephrectomy. The changes of serum creatinine, creatinine clearance and plasma ET - 1 level after intravenous injection of 76% diatrizoate meglumine (10 mg / kg) and the changes of ET - 1 and ET receptors A, B (ETR-A, ETR-B) expression. Results: After 8 weeks of unilateral nephrectomized diabetic rats, serum creatinine was higher than normal rats, the creatinine clearance rate and plasma endothelin - 1 concentration were significantly lower than those in normal rats (P <0. 0 (P <0.05). The levels of ET in plasma of diabetic rats were significantly higher than that of diabetic control group (P <0.05) - 1 concentration than the diabetic control group increased, but no significant difference. The expression of ET - 1, ETR - A and ETR - B in the tubulointerstitium of DM control group was significantly higher than that of the normal control group, and the expression of ETR - A and ETR - B increased significantly after injection of 76%. Conclusions: When diabetic renal insufficiency, the incidence of contrast-induced nephropathy may be related to the endothelin system, especially the renal endothelin system.