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犬水利尿期间适度的压力性利钠和自身调节

Modest pressure natriuresis and autoregulation during water diuresis in dogs.

作者信息

Waugh W H

机构信息

Department of Physiology, East Carolina University School of Medicine, Greenville, N.C.

出版信息

Blood Vessels. 1991;28(6):420-41. doi: 10.1159/000158890.

Abstract

The effects of renal arterial pressure change on renal output of sodium and volume were measured during water diuresis in 25 chloralose-anesthetized dogs. Conditions included a minimal invasive stress, limited sodium administration, and mean renal arterial pressures varied suprarenally, by aortic balloon inflation to lowermost levels of 82-106 mm Hg. Group A dogs received no aldosterone; group B, C and D dogs were given aldosterone. Dogs of group C also received (1-Sar, 8-Ile)-angiotensin II. Group D dogs received phenylephrine which elevated arterial and right atrial pressures moderately without decrease in renal blood flow. In groups A, B and C, mean changes in sodium output, volume output, fractional excretions and free water clearances were not detectable with mean renal arterial pressure reductions, which averaged 29 +/- 2.9, 22 +/- 2.8 and 27 +/- 5.2 mm Hg, respectively. Right atrial pressures, effective renal blood flows and glomerular filtration rates did not change with the renal arterial pressure changes in these groups. In the group D dogs, during the larger pressure reductions of 54 +/- 6.6 mm Hg from higher values of 158 +/- 7.0 mm Hg, mean urine flow and effective renal blood flow remained constant while glomerular filtration rate and sodium output decreased only slightly. Output efficiency ratios related to perfusion pressure were calculated. With no more than modest pressure-induced excretory changes, it is concluded that excretory sodium and urinary volume autoregulation in concert with nearly perfect circulatory autoregulation were demonstrated with regionally varied mean renal arterial pressure. The same preglomerular myogenic responses to transvascular pressure, which restrict glomerular and transcapillary pressures, are viewed dominantly responsible for both circulatory and excretory autoregulation under normal conditions of minimal stress and low fractional sodium excretions. Homeostatic implications are discussed concerning likely relevance to the Guyton-Coleman theory for the long-term control of arterial blood pressure.

摘要

在25只水合氯醛麻醉的犬进行水利尿期间,测量了肾动脉压力变化对钠排出量和尿量的影响。实验条件包括最小程度的侵入性应激、有限的钠摄入,通过主动脉球囊充气使平均肾动脉压力在肾上方变化至最低水平82 - 106 mmHg。A组犬未接受醛固酮;B组、C组和D组犬给予醛固酮。C组犬还接受了(1 - 肌氨酸,8 - 异亮氨酸) - 血管紧张素II。D组犬接受去氧肾上腺素,其适度升高动脉压和右心房压而不降低肾血流量。在A组、B组和C组中,平均肾动脉压力分别平均降低29±2.9、22±2.8和27±5.2 mmHg时,钠排出量、尿量、分数排泄率和自由水清除率的平均变化未被检测到。这些组的右心房压、有效肾血流量和肾小球滤过率并未随肾动脉压力变化而改变。在D组犬中,当平均肾动脉压力从较高值158±7.0 mmHg大幅降低54±6.6 mmHg时,平均尿流量和有效肾血流量保持恒定,而肾小球滤过率和钠排出量仅略有下降。计算了与灌注压力相关的排出效率比。在压力引起的排泄变化不超过适度范围的情况下,得出结论:在区域变化的平均肾动脉压力下,排泄钠和尿量的自身调节与几乎完美的循环自身调节协同发挥作用。在最小应激和低分数钠排泄的正常条件下,对跨血管压力的相同肾前肌源性反应(其限制肾小球和跨毛细血管压力)被认为是循环和排泄自身调节的主要原因。讨论了其稳态意义,涉及与Guyton - Coleman理论对动脉血压长期控制的可能相关性。

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