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血管紧张素I转换酶抑制剂对失血性休克时内分泌功能及肾灌注的影响

Effect of the inhibitor of angiotensin I converting enzyme on endocrine function and renal perfusion in haemorrhagic shock.

作者信息

Yamashita M, Oyama T, Kudo T

出版信息

Can Anaesth Soc J. 1977 Nov;24(6):695-701. doi: 10.1007/BF03006712.

Abstract

The present study was undertaken to investigate the effect of inhibition of angiotensin I converting enzyme on endocrine responses and renal perfusion in haemorrhagic shock. Plasma levels of vasopressin (VP), aldosterone, and plasma renin activity (PRA), and renal cortical tissue blood flow were measured both in control dogs and in those treated with an inhibitor of angiotensin I converting enzyme (SQ20881). The drug was administered with an intention of preventing vasoconstriction induced by angiotensin II and to improve tissue perfusion. No significant differences were found in plasma levels of vasopressin, aldosterone and plasma renin activity between control and SQ20881-treated groups. Secondary elevation of blood pressure following haemorrhage was significantly delayed and reduced by the administration of the inhibitor. Decrease in renal cortical tissue blood flow was observed in the SQ20881-treated group. It is suggested that angiotension II appears to play a role in spontaneous recovery of arterial blood pressure following haemorrhage. Furthermore, angiotensin II does not seem to play an important role in the stimulation of secretion of vasopressin in response to haemorrhage. Our data failed to demonstrate any favourable effects of inhibition of angiotension I converting enzyme on renal perfusion during haemorrhagic shock in dogs.

摘要

本研究旨在探讨抑制血管紧张素I转换酶对失血性休克时内分泌反应和肾灌注的影响。在对照犬和用血管紧张素I转换酶抑制剂(SQ20881)治疗的犬中,测量了血管加压素(VP)、醛固酮的血浆水平以及血浆肾素活性(PRA),并测量了肾皮质组织血流量。给予该药物的目的是防止血管紧张素II诱导的血管收缩并改善组织灌注。在对照组和SQ20881治疗组之间,血管加压素、醛固酮的血浆水平以及血浆肾素活性未发现显著差异。给予抑制剂后,出血后血压的继发性升高明显延迟且降低。在SQ20881治疗组中观察到肾皮质组织血流量减少。提示血管紧张素II似乎在出血后动脉血压的自发恢复中起作用。此外,血管紧张素II似乎在出血后刺激血管加压素分泌方面不起重要作用。我们的数据未能证明抑制血管紧张素I转换酶对犬失血性休克期间的肾灌注有任何有益作用。

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