Endo M
Department of Medicine, Kidney Center, Tokyo Women's Medical College.
Nihon Jinzo Gakkai Shi. 1991 Nov;33(11):1161-72.
Effect of angiotensin converting enzyme inhibitor (ACEI) and calcium channel blockers (CaB) on renal blood flow (RBF), glomerular filtration rate (GFR), and autoregulation (AR) of RBF were studied on the uninephrectomized spontaneously hypertensive rat (SHR) under the conditions of high (H) and low (L) salt loading. SHR was given with 0.9% or 0.09% NaCl solution as drinking water (GH, GL). Each group was divided into three groups for treatment with enalapril (Enp) and nitredipine (Nit); i.e. Enp group (GHE, GLE), Nit group (GHN, GLN) and control group (GHC, GLC). After 6 weeks, inulin clearance (Cin) was determined and RBF was measured by means of an electromagnetic flow meter. The renal arterial pressure was lowered by clamping and changes in RBF and AR were examined. Cin showed higher values of 1.85 and 1.69 ml/min in GHN and GLN, as compared to be 1.33 and 1.28 ml/min in GHC and GLC (p less than 0.01). Filtration fraction (FF) showed lower values of 0.18 and 0.20 ml/min in GHE and GLE (p less than 0.01), whereas 0.29 and 0.30 in GHC and GLC respectively. RBF was markedly lower at 7.4 ml/min in GLC as compared to 9.9 ml/min in GHC (p less than 0.01). In GH, GHE showed a higher value of 11.6 ml/min, as compared to GHC (p less than 0.01). In GL, comparing with GLC the value was much higher of 12.1 ml/min in GLE (p less than 0.01). AR of RBF diminished in GLC at higher blood pressure as compared to GHC (p less than 0.01). It was maintained at lower blood pressure in GLE (p less than 0.01), but there were no significant differences between four groups; i.e. GLN, GHC, GHE and GHN. In summary, low salt loading reduced RBF and suppressed AR. Enp elevated RBF, lowered FF and caused AR to be maintained even at lower blood pressure. Nit elevated RBF and GFR without changing FF, and did not suppress AR. These results indicate that, in hypertension complicated with moderate dysfunction, both ACEI and CAB are expected to exhibit the beneficial effects on maintenance of renal circulation, despite though the different mechanism.
在高盐(H)和低盐(L)负荷条件下,研究了血管紧张素转换酶抑制剂(ACEI)和钙通道阻滞剂(CaB)对单侧肾切除的自发性高血压大鼠(SHR)肾血流量(RBF)、肾小球滤过率(GFR)以及RBF自身调节(AR)的影响。给SHR饮用0.9%或0.09%的NaCl溶液(GH,GL)。每组再分为三组,分别用依那普利(Enp)和硝苯地平(Nit)进行治疗,即Enp组(GHE,GLE)、Nit组(GHN,GLN)和对照组(GHC,GLC)。6周后,测定菊粉清除率(Cin),并用电磁流量计测量RBF。通过夹闭降低肾动脉压,并检测RBF和AR的变化。与GHC和GLC组的1.33和1.28 ml/min相比,GHN和GLN组的Cin值较高,分别为1.85和1.69 ml/min(p<0.01)。滤过分数(FF)在GHE和GLE组较低,分别为0.18和0.20 ml/min(p<0.01),而GHC和GLC组分别为0.29和0.30。与GHC组的9.9 ml/min相比,GLC组的RBF显著降低,为7.4 ml/min(p<0.01)。在GH组,与GHC组相比,GHE组的RBF值较高,为11.6 ml/min(p<0.01)。在GL组,与GLC组相比,GLE组的RBF值更高,为12.1 ml/min(p<0.01)。与GHC组相比,GLC组在较高血压时RBF的AR减弱(p<0.01)。在GLE组,AR在较低血压时得以维持(p<0.01),但GLN、GHC、GHE和GHN这四组之间无显著差异。总之,低盐负荷降低了RBF并抑制了AR。Enp提高了RBF,降低了FF,并使AR即使在较低血压时也得以维持。Nit提高了RBF和GFR,而不改变FF,且不抑制AR。这些结果表明,在伴有中度功能障碍的高血压中,尽管机制不同,但ACEI和CaB均有望对维持肾循环发挥有益作用。