内皮素和一氧化氮与糖尿病肾病关系的研究进展(2)
此外，2型DM患者NO、ET及其比值的变化规律及其在DN发病中作用的研究显示[15]，NO/ET值在正常白蛋白尿组(NA)显著升高，微量白蛋白尿组(mA)和大量白蛋白尿组(MA)明显降低，表明在NO无显著变化的mA期，ET就开始发生变化，提示ET变化早于NO或ET高水平的保护作用使NO受到制约，而在此期间两组糖尿患者之间的代谢指标(OGTT、INS、C-P等)则无明显差异，提示未出现明显的代谢紊乱。
综上所述，ET和NO均重要的血管活性物质，且相互制约，在调节血管张力尤其是肾血流动力学方面起着重要的作用。当肾脏内皮细胞损伤时，ET/NO的制约平衡发生改变，特别是DN后期ET生成增加而NO合成受阻，即加剧了DN的进展。
参考文献：
[1] 关 欣，郑红光.细胞因子在糖尿病肾病发病中的作用[J].中国实用内科杂志，2005，25(3)：268.
, http://www.100md.com
[2] 刘志红，胡可斌，周 虹，等.2型糖尿病肾病患者肾组织中血管内皮细胞生长因子及其受体的变化[J].肾脏病与透析移植杂志，2001，10(5):401.
[3] Donald E，Kohen MD.Endothelin in normal and diseased kidney[J].Am J Kidney Dis，2002，29:2.
[4] Kohan DE.Endothelins in the normal and diseased kidney[J].Am J Kidney Dis，1997，29(1)：2.
[5] Ak G，Buyukberber S，Sevinc A，et al. The relation between plasma endothelin-1 levelsandmetabolic control risk factors treatment modalities and diabetic microangiopathy in patients with Type 2 dia-betes mellitus[J].J Diabetes Complications，2001，15(3):150.
, 百拇医药
[6] Chiarelli F，Cipollone F，Romano F，et al.Increased circulating nitric oxide in young patients with type 1 diabetes and persistent microal-buminuria：relation to glomerular hyperfilration[J].Diabetes，2000，49(7)：1258.
[7] Itoh Y，Imamura S，Yamamoto K，et al. Changes of endothelin in streptozotocin-induced diabetic rats: effects of an angiotensin con-verting enzyme inhibitor， enalapril maleate[J].J Endocrinol，2002，175(1):233.
[8] Itoh Y，Nakai A，Kakizawa H，et al.Alteration of endothelin-1 con-centration in STZ-induced diabetic rat nephropathy[J]. HormRes，2001，56(5~6):165.
, 百拇医药
[9] Neuhofer W，Pittrow D. Role of endothelin and endothelin receptorantagonists in renal disease[J].Eur J Clin Invest，2006，36 (l3):78.
[10] Zhao Y，Zhang XL.Effect of tongxinluo capsule on plasma endothe-lin in patients with diabetic nephropathy[J].中国中西医结合杂志，2005，25(2):131.
[11] Titon RG，Chang K，Hasan KS，et al.Prevention of diabetic vascular dysfunction by guanidine: inhibition of nitric oxide synthetase versus advanced glycosated end products formation[J].Diabetes，1993，42:221.
, http://www.100md.com
[12] Craven PA，Studer PK，De Rubertis FR. Impaired nitric oxide re-lease by glomerulifrom diabetic rats[J].Metabolism，1995，44:695.
[13] Fang YH，Zhang JP，Zhou SX，et al. Clinical analysis of serum en-dothelin in type 2 diabetic patients with vascular complications[J].Di Yi Jun Yi Da Xue Xue Bao，2005，25(8):1007.
[14] Shestakova MV，Jarek-Martynowa IR，Ivanishina NS，et al. Role of endothelial dysfunction in the development of cardiorenal syndrome in patients with type 1 diabetes mellitus[J].Diabetes Res Clin Pract，2005，68(l1):65.
[15] Craven PA，DeRubertis FR，Melhem M.Nitric oxide in diabetic ne-phropathy[J].Kidney Int Suppl，1997，60：546.
收稿日期：2008-04-10, 百拇医药(苗 淼 曹 硕 曹方方)
综上所述，ET和NO均重要的血管活性物质，且相互制约，在调节血管张力尤其是肾血流动力学方面起着重要的作用。当肾脏内皮细胞损伤时，ET/NO的制约平衡发生改变，特别是DN后期ET生成增加而NO合成受阻，即加剧了DN的进展。
参考文献：
[1] 关 欣，郑红光.细胞因子在糖尿病肾病发病中的作用[J].中国实用内科杂志，2005，25(3)：268.
, http://www.100md.com
[2] 刘志红，胡可斌，周 虹，等.2型糖尿病肾病患者肾组织中血管内皮细胞生长因子及其受体的变化[J].肾脏病与透析移植杂志，2001，10(5):401.
[3] Donald E，Kohen MD.Endothelin in normal and diseased kidney[J].Am J Kidney Dis，2002，29:2.
[4] Kohan DE.Endothelins in the normal and diseased kidney[J].Am J Kidney Dis，1997，29(1)：2.
[5] Ak G，Buyukberber S，Sevinc A，et al. The relation between plasma endothelin-1 levelsandmetabolic control risk factors treatment modalities and diabetic microangiopathy in patients with Type 2 dia-betes mellitus[J].J Diabetes Complications，2001，15(3):150.
, 百拇医药
[6] Chiarelli F，Cipollone F，Romano F，et al.Increased circulating nitric oxide in young patients with type 1 diabetes and persistent microal-buminuria：relation to glomerular hyperfilration[J].Diabetes，2000，49(7)：1258.
[7] Itoh Y，Imamura S，Yamamoto K，et al. Changes of endothelin in streptozotocin-induced diabetic rats: effects of an angiotensin con-verting enzyme inhibitor， enalapril maleate[J].J Endocrinol，2002，175(1):233.
[8] Itoh Y，Nakai A，Kakizawa H，et al.Alteration of endothelin-1 con-centration in STZ-induced diabetic rat nephropathy[J]. HormRes，2001，56(5~6):165.
, 百拇医药
[9] Neuhofer W，Pittrow D. Role of endothelin and endothelin receptorantagonists in renal disease[J].Eur J Clin Invest，2006，36 (l3):78.
[10] Zhao Y，Zhang XL.Effect of tongxinluo capsule on plasma endothe-lin in patients with diabetic nephropathy[J].中国中西医结合杂志，2005，25(2):131.
[11] Titon RG，Chang K，Hasan KS，et al.Prevention of diabetic vascular dysfunction by guanidine: inhibition of nitric oxide synthetase versus advanced glycosated end products formation[J].Diabetes，1993，42:221.
, http://www.100md.com
[12] Craven PA，Studer PK，De Rubertis FR. Impaired nitric oxide re-lease by glomerulifrom diabetic rats[J].Metabolism，1995，44:695.
[13] Fang YH，Zhang JP，Zhou SX，et al. Clinical analysis of serum en-dothelin in type 2 diabetic patients with vascular complications[J].Di Yi Jun Yi Da Xue Xue Bao，2005，25(8):1007.
[14] Shestakova MV，Jarek-Martynowa IR，Ivanishina NS，et al. Role of endothelial dysfunction in the development of cardiorenal syndrome in patients with type 1 diabetes mellitus[J].Diabetes Res Clin Pract，2005，68(l1):65.
[15] Craven PA，DeRubertis FR，Melhem M.Nitric oxide in diabetic ne-phropathy[J].Kidney Int Suppl，1997，60：546.
收稿日期：2008-04-10, 百拇医药(苗 淼 曹 硕 曹方方)