Bayati A, Nygren K, Källskog O, Wolgast M
Department of Physiology and Medical Biophysics, University of Uppsala, Sweden.
Acta Physiol Scand. 1990 Jun;139(2):271-9. doi: 10.1111/j.1748-1716.1990.tb08924.x.
The effects of continuous treatment with loop-acting diuretics on the long-term functional and histopathological outcome in kidneys subjected to 45 min of warm ischaemia were studied. One month after the primary damage the inulin clearance in the untreated kidneys was 0.44 +/- 0.05 ml min-1, improving significantly to 0.69 +/- 0.11 ml min-1 in furosemide-treated animals and to 0.75 +/- 0.09 ml min-1 in those treated with piretanide. Urine osmolality increased from 986 +/- 89 mosmol kg-1 in the untreated animals to 1479 +/- 195 mosmol kg-1 in the furosemide-treated ones. At the same time the total area of the outer medulla occupied by Tamm-Horsfall protein cylinders decreased from 7.0 +/- 1.2% in the untreated animals to 3.6 +/- 0.52% in the treated ones. It is concluded that by decreasing the number of nephrons blocked by Tamm-Horsfall cylinders an improvement in the function of ischaemically damaged kidneys can be achieved. This blockade, also called secondary damage, is of critical prognostic importance for the long-term outcome of the ischaemic renal failure. Treatment of the animals with loop diuretics decreased the occurrence of these cylinders, leading to an improvement of kidney function I month after the primary damage, this despite the fact that the primary damage seen in the early recirculation period was not treated specifically.
研究了用袢利尿剂持续治疗对经历45分钟热缺血的肾脏长期功能和组织病理学结果的影响。原发性损伤后1个月，未治疗的肾脏中菊粉清除率为0.44±0.05 ml·min⁻¹，在呋塞米治疗的动物中显著提高至0.69±0.11 ml·min⁻¹，在吡咯他尼治疗的动物中提高至0.75±0.09 ml·min⁻¹。尿渗透压从未治疗动物的986±89 mosmol·kg⁻¹增加到呋塞米治疗动物的1479±195 mosmol·kg⁻¹。与此同时，髓袢升支粗段蛋白管占据的外髓总面积从未治疗动物的7.0±1.2%降至治疗动物的3.6±0.52%。得出的结论是，通过减少被髓袢升支粗段蛋白管阻塞的肾单位数量，可以改善缺血性损伤肾脏的功能。这种阻塞，也称为继发性损伤，对缺血性肾衰竭的长期预后至关重要。用袢利尿剂治疗动物减少了这些蛋白管的发生，导致原发性损伤后1个月肾功能改善，尽管在早期再循环期看到的原发性损伤没有得到特异性治疗。
