血浆和尿中内皮素、一氧化氮在神经源性膀胱中的检测及意义

摘要

目的探讨内皮素和一氧化氮在神经源性膀胱病人血浆和尿中含量的变化及其临床意义。方法将2003年10月至2004年8月明确诊断的22例患儿作为实验组，均为反射亢进型膀胱源性膀胱。留取空腹血和晨尿，采用酶联免疫方法检测血浆和尿中内皮素（ET—1），一氧化氮（NO）含量，选取同期入院年龄匹配的儿童的血尿标本（腹股沟斜和鞘膜积液30例）设为对照组。结果实验组22例，血浆 ET—1含量（0．487±0．039）fmol／mL，NO 含量（69．57±36．68）μmol／L，尿中 ET —1含量为（0.453±0．029）fmol／mL，NO 含量（392．36±121．1）μmol／L。对照组血浆 ET —1含量（0．494±0.117） fmol／mL，NO 含量（74．56±11．39）μmol／L，尿中 ET—1含量（0．548±0.073）fmol／mL，NO 含量（268．92±88．38）μmol／L。实验组中血浆 ET—1含量高于尿中 ET—1含量（P ＜0．01），尿中 ET—1含量低于对照组（P ＜0．05），尿中 NO 含量高于对照组（P ＜0．05）；血浆中 ET —1、NO 含量较对照组无明显差异（P ＞0.05）。结论反射亢进型神经源性膀胱病人血浆中 ET 和 NO 的含量处于正常水平；而尿中 ET—1和NO 比例失衡。%Objective To explore the quantity of endothelin and nitrogen monoxidum in blood plasm and urinary and it's significance in neurogenic bladder diseases. Methods The 22 patients of neurogenic bladder were from the period during October 2003 to August 2004,10 months ~14 years old,the average was 6.28 ± 3.12 years old.All patients underwent urodynamic study,nervous electromyogram,voiding cysto urethro gra-phy and intravenous pyelography(IVP).Using zymo-immunity,we detected the contents of endothelin and ni-trogen monoxidum blood of empty stomach and urina sanguinis.And using chrome disoxidation biochemistry,we detected nitrogen monoxidum(NO)from blood and urinary,and control group age match 30 cases (oblique in-guinal hernia and funicular hydrocele). Results All patients suffered to hyperreflexia.The endothelin-1 in plasma was *0.487 ±0.039)fmol/mL,and in the urinary was (0.453 ±0.029)fmol/mL,NO in plasma was (69.57 ±36.68)μmol/L,and in the urinary was (392.36 ±121.1)μmol/L.In control group the endothelin-1 in plasma was (0.494 ±0.117)fmol/mL,and in the urinary was (0.548 ±0.073)fmol/mL.NO in plasma was (74.56 ±11.39)μmol/L,and in the urinary was (268.92 ±88.38)μmol/L .Endothein-1 in plasma was higher than in urinary(P <0.01),and NO in the urinary was higher than that of normal children(P <0.05).Endothelin-1 and NO of plasma in neurogenic bladders were not significant with normal children(P >0.05). Conclusion Endothelin and NO in plasma are at the normal level in hyperreflexia patients,but in the urinary lied disproportion of endothelin and NO,and endothelin is higher,and NO is lower than normal.