Torsello G, Schrör K, Szabo Z, Kutkuhn B, Strobach H, Godehardt E, Sandmann W
Department of Vascular Surgery and Renal Transplantation, University of Düsseldorf, West Germany.
Eur J Vasc Surg. 1989 Feb;3(1):5-13. doi: 10.1016/s0950-821x(89)80101-x.
A persisting incidence of acute renal failure has been observed after operative treatment of thoracoabdominal aortic aneurysm, ruptured abdominal aortic aneurysm and renal artery occlusive disease in patients with preoperative impairment of renal function. Because preservation of kidney function can play an important role in the outcome of these patients, the effects of prostaglandin E1 (PGE1) to prevent ischaemic renal failure were studied in an experimental model. Twenty dogs were exposed to 3 h warm ischaemia by clamping of the supra- and infrarenal aorta and both renal arteries. In 10 dogs PGE1 was given intravenously (100 ng/kg/min) for 15 min before clamping. Ten dogs treated with normal saline served as controls. Glomerular filtration rate, renal plasma flow, plasma creatinine, blood urea nitrogen, urine volume, free water clearance and renovascular resistance were calculated before and after renal ischaemia for both groups. The dogs were followed-up for 2 weeks and radionuclide studies with Tc-99m-MAG3, I-131-OIH and In-113m-DTPA were performed on the third postoperative day to calculate global and split renal clearance, tracer extraction fraction and mean transport time. After renal ischemia 9 dogs of the control group and 3 dogs of the PGE1-group developed acute renal failure (P less than 0.05 due to Fisher's exact text). PGE1 infusion significantly attenuated the postischaemic fall in glomerular filtration rate and renal concentrating ability as well as the postischaemic increase of plasma creatinine and blood urea nitrogen induced by 3 h warm renal ischaemia (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
在肾功能术前受损的患者中，经手术治疗胸腹主动脉瘤、破裂性腹主动脉瘤和肾动脉闭塞性疾病后，急性肾衰竭的发生率持续存在。由于肾功能的保留对这些患者的预后起着重要作用，因此在一个实验模型中研究了前列腺素E1（PGE1）预防缺血性肾衰竭的效果。20只狗通过夹闭肾动脉上下方的主动脉和双侧肾动脉，使其经历3小时的热缺血。10只狗在夹闭前15分钟静脉注射PGE1（100纳克/千克/分钟）。10只接受生理盐水治疗的狗作为对照。计算两组肾缺血前后的肾小球滤过率、肾血浆流量、血浆肌酐、血尿素氮、尿量、自由水清除率和肾血管阻力。对这些狗进行了2周的随访，并在术后第三天用锝-99m-巯基乙酰三甘氨酸（Tc-99m-MAG3）、碘-131-邻碘马尿酸（I-131-OIH）和铟-113m-二乙三胺五醋酸（In-113m-DTPA）进行放射性核素研究，以计算总肾和分肾清除率、示踪剂提取分数和平均转运时间。肾缺血后，对照组9只狗和PGE1组3只狗发生了急性肾衰竭（由于Fisher精确检验，P<0.05）。PGE1输注显著减轻了3小时热肾缺血引起的缺血后肾小球滤过率和肾浓缩能力的下降，以及血浆肌酐和血尿素氮的缺血后升高（P<0.05）。（摘要截短于250字）
