Goodman T A, Gerard D F, Bernstein E F, Dilley R B
Surgery. 1976 Jul;80(1):31-9.
The effects of pulseless perfusion on the distribution of renal blood flow and on release of renin were studied in anesthetized dogs. The distribution of renal blood flow to four cortical layers was determined with the radioactive microsphere technique during pulsatile control conditions and after one and 2 hours of pulseless perfusion, without significant changes in mean arterial pressure and mean total renal blood flow. Simultaneously, renal vein blood samples were analyzed for renin (radioimmunoassay technique). During pulseless perfusion there was a consistent and progressive redistribution of blood flow toward deeper cortical layers with the outer cortical layer falling from 36.9 to 25.3% p less than 0.001) and the juxtamedullary cortex increasing from 14.5 to 25.4% (p less than 0.001) after 2 hours. In addition, there was a progressive increase in renal venous concentration of renin, which was 20.91 +/- 6.6 ng. per millimeter per hour after 2 hours of pulseless flow compared to 5.06 +/- 1.16 ng. per millimeter per hour during control conditions (p less than 0.05). These changes in cortical blood flow and in release of renin were not observed in sham-operated controls. The results indicate that pulseless flow alone produced both a significant increase in renal production of renin and a significant redistribution of renal cortical blood flow, due to the greater vasoconstriction in the outer cortex when compared to the juxtamedullary cortex.
在麻醉犬身上研究了无搏动灌注对肾血流分布和肾素释放的影响。在搏动性对照条件下以及无搏动灌注1小时和2小时后,采用放射性微球技术测定肾血流在四个皮质层的分布,此时平均动脉压和平均总肾血流量无显著变化。同时,对肾静脉血样本进行肾素分析(放射免疫测定技术)。在无搏动灌注期间,血流持续且逐渐地向更深的皮质层重新分布,2小时后,外层皮质层血流占比从36.9%降至25.3%(p<0.001),近髓质皮质层血流占比从14.5%增至25.4%(p<0.001)。此外,肾静脉肾素浓度逐渐升高,无搏动血流2小时后为20.91±6.6纳克/毫米·小时,而对照条件下为5.06±1.16纳克/毫米·小时(p<0.05)。在假手术对照组中未观察到皮质血流和肾素释放的这些变化。结果表明,仅无搏动血流就导致肾素生成显著增加以及肾皮质血流显著重新分布,这是由于外层皮质与近髓质皮质相比血管收缩更强。