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通过慢性血流测量和传递函数分析揭示的糖尿病早期肾血流控制机制。

Mechanisms for renal blood flow control early in diabetes as revealed by chronic flow measurement and transfer function analysis.

作者信息

Bell Tracy D, DiBona Gerald F, Wang Ying, Brands Michael W

机构信息

Department of Physiology, Medical College of Georgia, Augusta State University, Augusta, GA 30912-3000, USA.

出版信息

J Am Soc Nephrol. 2006 Aug;17(8):2184-92. doi: 10.1681/ASN.2006030216. Epub 2006 Jun 28.

Abstract

The purpose of this study was to establish the roles of the myogenic response and the TGF mechanism in renal blood flow (RBF) control at the very earliest stages of diabetes. Mean arterial pressure (MAP) and RBF were measured continuously, 18 h/d, in uninephrectomized control and diabetic rats, and transfer function analysis was used to determine the dynamic autoregulatory efficiency of the renal vasculature. During the control period, MAP averaged 91 +/- 0.5 and 89 +/- 0.4 mmHg, and RBF averaged 8.0 +/- 0.1 and 7.8 +/- 0.1 ml/min in the control and diabetic groups, respectively. Induction of diabetes with streptozotocin caused a marked and progressive increase in RBF in the diabetic rats, averaging 10 +/- 6% above control on day 1 of diabetes and 22 +/- 3 and 34 +/- 1% above control by the end of diabetes weeks 1 and 2. MAP increased approximately 9 mmHg during the 2 wk in the diabetic rats, and renal vascular resistance decreased. Transfer function analysis revealed significant increases in gain to positive values over the frequency ranges of both the TGF and myogenic mechanisms, beginning on day 1 of diabetes and continuing through day 14. These very rapid increases in RBF and transfer function gain suggest that autoregulation is impaired at the very onset of hyperglycemia in streptozotocin-induced type 1 diabetes and may play an important role in the increase in RBF and GFR in diabetes. Together with previous reports of decreases in chronically measured cardiac output and hindquarter blood flow, this suggests that there may be differential effects of diabetes on RBF versus nonrenal BF control.

摘要

本研究的目的是确定在糖尿病最早期阶段,肌源性反应和转化生长因子(TGF)机制在肾血流(RBF)控制中的作用。对单侧肾切除的对照大鼠和糖尿病大鼠,每天连续18小时测量平均动脉压(MAP)和RBF,并采用传递函数分析来确定肾血管系统的动态自动调节效率。在对照期,对照组和糖尿病组的MAP平均分别为91±0.5和89±0.4 mmHg,RBF平均分别为8.0±0.1和7.8±0.1 ml/min。链脲佐菌素诱导糖尿病导致糖尿病大鼠的RBF显著且逐渐增加,糖尿病第1天平均比对照高10±6%,糖尿病第1周和第2周结束时分别比对照高22±3%和34±1%。糖尿病大鼠在2周内MAP升高约9 mmHg,肾血管阻力降低。传递函数分析显示,从糖尿病第1天开始直至第14天,在TGF和肌源性机制的频率范围内,增益显著增加至正值。RBF和传递函数增益的这些非常迅速的增加表明,在链脲佐菌素诱导的1型糖尿病中,高血糖发作伊始自动调节就受损,且可能在糖尿病时RBF和肾小球滤过率(GFR)增加中起重要作用。连同先前关于慢性测量的心输出量和后肢血流量减少的报道,这表明糖尿病对RBF与非肾血流控制可能有不同影响。

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