Granger J P, Alberola A M, Salazar F J, Nakamura T
Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson 39216-4505.
J Cardiovasc Pharmacol. 1992;20 Suppl 12:S160-2. doi: 10.1097/00005344-199204002-00045.
Systemic blockade of nitric oxide (NO) synthesis results in marked increases in the renal vascular resistance (RVR) and decreases in the glomerular filtration rate (GFR) and renal plasma flow (RPF). The renal hemodynamic effect of systemic NO blockade is most likely due to an integration of direct and indirect renal actions. The quantitative importance of local intrarenal blockade of NO synthesis on renal hemodynamics has not been fully elucidated. Therefore, the purpose of this study was to compare the renal hemodynamic effects of intrarenal vs. systemic NO synthesis blockade on renal hemodynamics. Nitro-L-arginine methyl ester (L-NAME) was infused intrarenally at a rate of 3 micrograms/kg/min for 180 min in conscious chronically instrumented dogs (n = 7). Intrarenal infusion of L-NAME for 180 min resulted in a 12% decrease in RPF, 14% increase in RVR, and no effect on mean arterial pressure (MAP) or GFR. In contrast, infusion of L-NAME intravenously at a rate of 10 micrograms/kg/min for 180 min increased the RVR by 124% and decreased the RPF by 55% and GFR by 45%. The MAP and heart rate both increased in response to intravenous administration of L-NAME. The results of this study suggest that the renal hemodynamic effects of systemic administration of L-NAME may, in large part, be secondary to extrarenal effects of NO synthesis blockade, possibly via activation of the sympathetic nervous system.
一氧化氮(NO)合成的全身阻断会导致肾血管阻力(RVR)显著增加,肾小球滤过率(GFR)和肾血浆流量(RPF)降低。全身NO阻断对肾血流动力学的影响很可能是直接和间接肾脏作用综合作用的结果。局部肾内NO合成阻断对肾血流动力学的定量重要性尚未完全阐明。因此,本研究的目的是比较肾内与全身NO合成阻断对肾血流动力学的影响。在清醒的慢性植入仪器的犬(n = 7)中,以3微克/千克/分钟的速率肾内输注硝基-L-精氨酸甲酯(L-NAME)180分钟。肾内输注L-NAME 180分钟导致RPF降低12%,RVR增加14%,对平均动脉压(MAP)或GFR无影响。相比之下,以10微克/千克/分钟的速率静脉输注L-NAME 180分钟,使RVR增加124%,RPF降低55%,GFR降低45%。静脉注射L-NAME后,MAP和心率均升高。本研究结果表明,全身给予L-NAME对肾血流动力学的影响可能在很大程度上继发于NO合成阻断的肾外效应,可能是通过激活交感神经系统。