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两种静脉输注氨基酸方案对健康人肾血流动力学、肾小管功能及钠水稳态激素的影响

Effect of two regimens of intravenous amino acid infusion on renal haemodynamics, renal tubular function and sodium and water homeostatic hormones in healthy humans.

作者信息

Sørensen S S, Lauridsen I N, Thomsen K, Pedersen E B

机构信息

Department of Medicine C, Aarhus Kommunehospital, Denmark.

出版信息

Nephrol Dial Transplant. 1991;6(6):410-9. doi: 10.1093/ndt/6.6.410.

Abstract

The effect of two different regimens of intravenous infusion of amino acids on glomerular filtration rate (GFR), renal plasma flow (RPF), tubular sodium and water handling judged from the clearance of lithium (CLi), and plasma concentrations of angiotensin II (Ang II), aldosterone (Aldo), arginine vasopressin (AVP), atrial natriuretic peptide (ANP), growth hormone (GH), and glucagon was investigated in healthy humans. In the first protocol (n = 11) the infusion lasted 90 min; both GFR and RPF increased significantly (median increase 7.1% and 9.1% respectively, P less than 0.05 both). In the second protocol (n = 13) the infusion lasted 30 min; both GFR and RPF tended to increase (median increase 3.5% and 7.4%) but the change did not reach significance. The changes in tubular sodium and water handling were similar in the two protocols. Absolute reabsorption rates in the proximal tubules were unaltered, resulting in an increased output into the distal tubules that was totally compensated for by an increased distal reabsorption. Thus no changes in urinary excretion of sodium and water were observed. Ang II, Aldo, AVP, ANP and GH were unchanged by amino acid infusion, but glucagon increased. It is suggested that the alterations in renal haemodynamics and distal tubular reabsorption may be mediated by glucagon.

摘要

在健康人体中,研究了两种不同的静脉输注氨基酸方案对肾小球滤过率(GFR)、肾血浆流量(RPF)、根据锂清除率(CLi)判断的肾小管钠和水处理情况以及血管紧张素II(Ang II)、醛固酮(Aldo)、精氨酸加压素(AVP)、心房利钠肽(ANP)、生长激素(GH)和胰高血糖素血浆浓度的影响。在第一个方案(n = 11)中,输注持续90分钟;GFR和RPF均显著增加(中位数分别增加7.1%和9.1%,P均小于0.05)。在第二个方案(n = 13)中,输注持续30分钟;GFR和RPF均有增加趋势(中位数增加3.5%和7.4%),但变化未达到显著水平。两个方案中肾小管钠和水处理的变化相似。近端小管的绝对重吸收率未改变,导致进入远端小管的输出增加,而远端重吸收增加完全补偿了这一增加。因此,未观察到钠和水的尿排泄变化。氨基酸输注后,Ang II、Aldo、AVP、ANP和GH未改变,但胰高血糖素增加。提示肾血流动力学和远端小管重吸收的改变可能由胰高血糖素介导。

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