Carstens Jan, Pedersen Erling Bjerregaard
Holstebro Hospital, Aarhus University, Department of Medical Research, Holstebro, Denmark.
Scand J Clin Lab Invest. 2008;68(1):2-10. doi: 10.1080/00365510701504257. Epub 2007 Nov 21.
Little is known about the role of the renin-angiotensin-aldosterone system and the renal prostaglandins in modulating the renal vasoconstrictive and natriuretic effects of synthetic urodilatin (URO) in healthy humans.
Twelve volunteers were pretreated in a randomized, single-blind, crossover study with losartan 50 mg a day or placebo for 5 days. Another 12 healthy subjects received indomethacin 25 mg three times a day or placebo for 4 days and a single dose on day 5. All subjects received a URO infusion (15 ng kg(-1) min(-1)) on day 5. Radioactive tracers and the lithium clearance technique were used.
The effective renal plasma flow (ERPF) decreased significantly during URO infusion: losartan pretreatment 573+/-63 to 461+/-76 mL/min versus placebo 540+/-89 to 432+/-90 mL/min. The urinary sodium excretion rate (UNa) increased significantly during URO infusion: losartan 335+/-115 to 502+/-134 umol/min (micromol/min) (UNa) versus placebo 386+/-142 to 476+/-137 umol/min (micromol/min) (UNa). In the indomethacin pretreated subjects, ERPF decreased significantly from 530+/-109 to 446+/-55 mL/min versus 533+/-89 to 449+/-69 mL/min in the placebo group. UNa increased significantly from 395+/-142 to 768+/-254 umol/min (micromol/min) (UNa) in the indomethacin group versus 282+/-117 to 552+/-242 umol/min (micromol/min) (UNa) in placebo.
The renal vasoconstrictive and natriuretic effects of synthetic URO are not modified by sustained inhibition of the angiotensin II receptor or the cyclooxygenase in man in a sodium replete state.
关于肾素 - 血管紧张素 - 醛固酮系统和肾前列腺素在调节合成尿舒张素(URO)对健康人肾血管收缩和利钠作用中的作用,人们了解甚少。
在一项随机、单盲、交叉研究中,12名志愿者每天接受50毫克氯沙坦或安慰剂预处理5天。另外12名健康受试者每天三次接受25毫克吲哚美辛或安慰剂治疗4天,并在第5天接受单剂量治疗。所有受试者在第5天接受URO输注(15纳克·千克⁻¹·分钟⁻¹)。使用放射性示踪剂和锂清除技术。
URO输注期间有效肾血浆流量(ERPF)显著下降:氯沙坦预处理组从573±63降至461±76毫升/分钟,而安慰剂组从540±89降至432±90毫升/分钟。URO输注期间尿钠排泄率(UNa)显著增加:氯沙坦组从335±115升至502±134微摩尔/分钟(μmol/min)(UNa),而安慰剂组从386±142升至476±137微摩尔/分钟(μmol/min)(UNa)。在吲哚美辛预处理的受试者中,ERPF从530±109显著降至446±55毫升/分钟,而安慰剂组从533±89降至449±69毫升/分钟。吲哚美辛组UNa从395±142显著升至768±254微摩尔/分钟(μmol/min)(UNa),而安慰剂组从282±117升至552±242微摩尔/分钟(μmol/min)(UNa)。
在钠充足状态下,对人持续抑制血管紧张素II受体或环氧化酶不会改变合成URO的肾血管收缩和利钠作用。