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“阶梯式”与“动态”自动调节:对高血压性损伤易感性的影响

"Step" vs. "dynamic" autoregulation: implications for susceptibility to hypertensive injury.

作者信息

Bidani Anil K, Hacioglu Rifat, Abu-Amarah Isam, Williamson Geoffrey A, Loutzenhiser Rodger, Griffin Karen A

机构信息

Department of Internal Medicine, Loyola University Medical Center and Edward Hines, Jr., Veterans Affairs Hospital, Maywood 60153, USA.

出版信息

Am J Physiol Renal Physiol. 2003 Jul;285(1):F113-20. doi: 10.1152/ajprenal.00012.2003. Epub 2003 Mar 11.

Abstract

Renal autoregulatory (AR) mechanisms provide the primary protection against transmission of systemic pressures, and their impairment is believed to be responsible for the enhanced susceptibility to hypertensive renal damage in renal mass reduction (RMR) models. Assessment of AR capacity by the "step" change methodology under anesthesia was compared with that by "dynamic" methods in separate conscious control Sprague-Dawley rats and after uninephrectomy (UNX) and (3/4) RMR (RK-NX) (n = 7-10/group). Substantially less AR capacity was seen by the dynamic vs. the step methodology in control rats. Moreover, dynamic AR capacity did not differ among controls, UNX, and RK-NX rats (fractional gain in admittance approximately 0.4-0.5 in all groups at frequencies in the range of 0.0025-0.025 Hz). By contrast, significant impairment of step AR was seen in RK-NX vs. control or UNX rats (AR indexes 0.7 +/- 0.1 vs. 0.1 +/- 0.02 and 0.2 +/- 0.04, respectively, P < 0.01). We propose that the step and dynamic methods evaluate the renal AR responses to different components of blood pressure (BP) power with the step AR assessing the ability to buffer large changes in average BP (DC power), whereas the present "dynamic" methods assess the AR ability to buffer slow BP fluctuations (<0.25 Hz) superimposed on the average BP (AC power), a substantially smaller component of total BP power. We further suggest that step but not dynamic AR methods as presently performed provide a valid index of the underlying susceptibility to hypertensive glomerular damage after RMR.

摘要

肾脏自身调节(AR)机制为抵御全身压力的传递提供了主要保护,并且人们认为其功能受损是导致肾质量减少(RMR)模型中对高血压肾损伤易感性增加的原因。在单独的清醒对照Sprague-Dawley大鼠以及单侧肾切除(UNX)和(3/4)RMR(RK-NX)后(每组n = 7 - 10),通过麻醉下的“阶梯”变化方法评估AR能力,并与“动态”方法进行比较。与阶梯法相比,在对照大鼠中动态法观察到的AR能力明显较低。此外,对照、UNX和RK-NX大鼠之间的动态AR能力没有差异(在0.0025 - 0.025 Hz频率范围内,所有组的导纳分数增益约为0.4 - 0.5)。相比之下,与对照或UNX大鼠相比,RK-NX大鼠的阶梯AR有明显损伤(AR指数分别为0.7±0.1、0.1±0.02和0.2±0.04,P < 0.01)。我们提出,阶梯法和动态法评估肾脏AR对血压(BP)功率不同成分的反应,阶梯AR评估缓冲平均BP大幅变化(直流功率)的能力,而目前的“动态”方法评估缓冲叠加在平均BP上的缓慢BP波动(<0.25 Hz)(交流功率)的AR能力,这是总BP功率中一个小得多的成分。我们进一步建议,目前所采用的阶梯而非动态AR方法可作为RMR后高血压肾小球损伤潜在易感性的有效指标。

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