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对26例流行性出血热(EHF)患者测定了肾小球滤过率(GFR)和有效肾血浆流量(ERPF),并以18名健康人作对照。结果显示EHF患者从发热后期至多尿期GFR与ERPF均显著下降,重型较中型下降更著。用放免法同步检测了血浆血管紧张素一Ⅱ(AT一Ⅱ)、血栓素B2(TXB2)和6一酮一前列腺素F_1α(6一K一PGF_1α),发现病程前三期AT一Ⅱ和TXB2显著增高,6一K一PGF_1α变化不大或稍微降低,致TXB2/6一K一PGF_1α比值明显上升。我们认为有效血容量降低和若干体液因子的变化是导致GFR与ERPF下降的主要原因,而肾脏血液动力学变化又是造成EHF肾功能损害诸因素中一个重要因素。
Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured in 26 patients with epidemic hemorrhagic fever (EHF) and 18 healthy controls were used. The results showed that EHF patients from the late fever to polyuria, GFR and ERPF were significantly decreased, more severe than the moderate drop even more. The plasma levels of AT-Ⅱ, TXB2 and 6-keto-PGF_1α (6-K-PGF_1α) were simultaneously detected by radioimmunoassay. The first three stages of AT-Ⅱ and TXB2 Significantly increased, 6 K-PGF_1α little or slightly reduced, resulting in TXB2 / 6 a K-PGF_1α ratio increased significantly. We think that the decrease of effective blood volume and the change of some humoral factors are the main reasons leading to the decrease of GFR and ERPF, and that the change of renal hemodynamics is an important factor in the renal damage caused by EHF.