Bailie M D
University of Illinois College of Medicine, Peoria.
Clin Perinatol. 1992 Mar;19(1):59-68.
The kidney is a complex endocrine organ, and many of the renal hormones have actions that help regulate renal function. Although we have much more to learn about the role of most of these hormones in the regulation of renal function in both the newborn and adult kidney, there are some important aspects to keep in mind as we approach therapeutic interventions in sick newborn and premature infants. Because of the many interactions between hormonal systems, drugs that we may use for specific actions on one system may have effects on others as well (ACE inhibitors, cyclooxygenase inhibitors, dopamine antagonists). In addition, it is clear that the state of the organism may play a role in which of the renal hormones is active. Finally, the nonrenal hormonal systems that affect renal function (aldosterone, atrial natriuretic peptide, vasopressin, etc) may interact to change further expected results of any therapeutic intervention. Therefore, it behooves the clinician to monitor carefully renal function whenever modifications in therapy are made, whether it is a change in mechanical or pharmacologic intervention.
肾脏是一个复杂的内分泌器官，许多肾激素具有有助于调节肾功能的作用。尽管我们对于大多数这些激素在新生儿和成人肾脏的肾功能调节中的作用还有很多需要了解的地方，但在我们对患病新生儿和早产儿进行治疗干预时，有一些重要方面需要牢记。由于激素系统之间存在许多相互作用，我们可能用于对一个系统进行特定作用的药物也可能对其他系统产生影响（如血管紧张素转换酶抑制剂、环氧化酶抑制剂、多巴胺拮抗剂）。此外，很明显机体状态可能在哪些肾激素处于活性状态方面发挥作用。最后，影响肾功能的非肾激素系统（醛固酮、心钠素、血管加压素等）可能相互作用，从而进一步改变任何治疗干预的预期结果。因此，无论进行机械干预还是药物干预的调整，临床医生在进行治疗调整时都理应仔细监测肾功能。
