Tsuji Y, Goldfarb D A, Masaki Z, Ferrario C M
Department of Brain and Vascular Research, Cleveland Clinic Foundation, Ohio 44195.
Clin Exp Hypertens A. 1992;14(6):1067-81. doi: 10.3109/10641969209038193.
We performed renal function studies in dogs with chronic renovascular hypertension produced by complete occlusion of a renal artery. In addition, we evaluated in anesthetized dogs the acute effects of a novel angiotensin converting enzyme inhibitor, CGS 16,617, on renal function and plasma neurohormones (epinephrine, norepinephrine and vasopressin) 4 weeks after initiation of 2 kidney, 1 clip hypertension. CGS 16,617 effectively decreased blood pressure in renal hypertensive animals. This response was associated with suppression of angiotensin II indicating effective converting enzyme inhibition. In the non-clipped kidney, acute administration of CGS 16,617 increased effective renal plasma flow but not glomerular filtration rate and urinary sodium excretion. In the clipped kidney, CGS 16,617 caused no change in any parameter of renal function. Plasma norepinephrine, epinephrine and vasopressin were unaffected by administration of CGS 16,617. These studies showed that chronic occlusion of a renal artery does not result in renal infarction because of a compensatory increase in the amount of blood provided through capsular collateral vessels. The collateral circulation which has developed in the clipped kidney explains the lack of a converting enzyme inhibitor effect.
我们对因肾动脉完全闭塞所致慢性肾血管性高血压的犬进行了肾功能研究。此外，在两肾一夹高血压模型建立4周后，我们评估了新型血管紧张素转换酶抑制剂CGS 16,617对麻醉犬肾功能和血浆神经激素（肾上腺素、去甲肾上腺素和血管加压素）的急性影响。CGS 16,617可有效降低肾性高血压动物的血压。该反应与血管紧张素II的抑制相关，表明其对转换酶具有有效的抑制作用。在未夹闭的肾脏中，急性给予CGS 16,617可增加有效肾血浆流量，但肾小球滤过率和尿钠排泄无变化。在夹闭的肾脏中，CGS 16,617对任何肾功能参数均无影响。给予CGS 16,617后，血浆去甲肾上腺素、肾上腺素和血管加压素未受影响。这些研究表明，肾动脉的慢性闭塞不会导致肾梗死，这是因为通过包膜侧支血管提供的血量代偿性增加。夹闭肾脏中已形成的侧支循环解释了转换酶抑制剂缺乏效应的原因。
