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目的为了解内皮素（ＥＴ）及降钙素基因相关肽（ＣＧＲＰ）与糖尿患者不同阶段时肾血流的关系。方法肾彩色多普勒超声检查确定为糖尿病肾血流正常组（Ａ组）１５例、糖尿病肾血流减少组（Ｂ组）１５例，正常对照组１８例。分别采血测定血浆ＥＴ－１和ＣＧＲＰ浓度。结果Ａ组ＥＴ－１水平低于正常对照组（Ｐ＜０．０１），Ｂ组ＥＴ－１水平高于正常对照组（Ｐ＜０．０１）。二组ＥＴ－１水平与肾动脉收缩期峰值血流速度（Ｖｍａｘ）、肾动脉血流量（Ｑ）呈负相关（Ｐ＜０．０１），与尿白蛋白排泄率（ＵＡＥＲ）呈正相关（Ｐ＜０．０５）。二组的ＣＧＲＰ水平均低于正常组（Ｐ均＜０．０１），但Ａ与Ｂ组的ＣＧＲＰ水平差异无显著性（Ｐ＞０．０５）。未发现ＣＧＲＰ水平与Ｖｍａｘ、Ｑ和ＵＡＥＲ呈相关关系。结论ＥＴ－１在糖尿病不同阶段时对肾血流量的病理生理作用可能不同；糖尿病患者呈现低ＣＧＲＰ血症，但它对不同阶段的糖尿病肾血流的影响尚有待探讨。
Objective To understand the relationship between endothelin (ET) and calcitonin gene-related peptide (CGRP) and renal blood flow in different stages of diabetic patients. Methods Fifteen patients with normal renal blood flow (group A), 15 patients with diabetic renal blood flow reduction (group B) and 18 normal controls were identified by color Doppler sonography. Blood samples were collected for determination of ET-1 and CGRP levels. Results The level of ET-1 in group A was lower than that in normal control group (P <0.01). The ET-1 level in group B was higher than that of control group (P <0.01). The ET-1 levels in the two groups were negatively correlated with peak renal artery systolic velocity (Vmax) and renal artery blood flow (Q) (P <0.01), and positively correlated with urinary albumin excretion rate (UAER) <0.05). The levels of CGRP in both groups were lower than those in normal group (all P <0.01), but there was no significant difference in CGRP between groups A and B (P> 0.05). No correlation was found between CGRP levels and Vmax, Q and UAER. Conclusion The pathophysiological effects of ET-1 on renal blood flow may be different during different stages of diabetes. Diabetic patients have low CGRP. However, the effect of ET-1 on diabetic renal blood flow in different stages remains to be explored.