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在既往存在肾灌注不足的情况下,低血压期间肾小球滤过率(GFR)的保存受损。

Impaired preservation of GFR during hypotension in preexistent renal hypoperfusion.

作者信息

Yoshioka T, Yared A, Kon V, Ichikawa I

机构信息

Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee 37232.

出版信息

Am J Physiol. 1989 Feb;256(2 Pt 2):F314-20. doi: 10.1152/ajprenal.1989.256.2.F314.

Abstract

Autoregulation of renal blood flow and filtration rate was studied using micropuncture technique in Munich-Wistar rats with acute water deprivation (AWD) or congestive heart failure (CHF). In the first set of experiments, reduction of renal perfusion pressure to approximately to 70% of its initial value resulted in uncoupling of glomerular plasma flow rate and single-nephron glomerular filtration rate (GFR) (i.e., disproportionally profound fall in the latter) in AWD and CHF rats, whereas both indices changed little in normal control (NC) rats. The profound decrease in single-nephron GFR in AWD and CHF rats was primarily due to a reduction in glomerular capillary pressure (change from base-line value was -29 +/- 2% in AWD, -27 +/- 1% in CHF, and -8 +/- 2% in NC). This profound fall in glomerular capillary pressure in AWD and CHF rats was associated with a reduction in efferent arteriolar resistance, which contrastingly increased in NC. To investigate the mechanism underlying this unique efferent arteriolar responsiveness in AWD and CHF, the response of renal arterioles to exogenous angiotensin II was examined in separate groups of AWD, CHF, and NC. There was a markedly attenuated efferent arteriolar vasoconstrictive response in AWD and CHF (the change of efferent arteriolar resistance in both groups was some 5% of that in NC). Thus impairment in the ability to preserve GFR in these two conditions is attributed, at least in part, to altered efferent arteriolar response in the face of reduced renal perfusion pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

利用微穿刺技术,在急性缺水(AWD)或充血性心力衰竭(CHF)的慕尼黑-威斯塔大鼠中研究了肾血流量和滤过率的自身调节。在第一组实验中,将肾灌注压降低至其初始值的约70%,导致AWD和CHF大鼠的肾小球血浆流速和单肾单位肾小球滤过率(GFR)解偶联(即后者不成比例地大幅下降),而在正常对照(NC)大鼠中,这两个指标变化很小。AWD和CHF大鼠单肾单位GFR的显著降低主要是由于肾小球毛细血管压力降低(AWD组从基线值变化为-29±2%,CHF组为-27±1%,NC组为-8±2%)。AWD和CHF大鼠肾小球毛细血管压力的显著下降与出球小动脉阻力降低有关,相比之下,NC组出球小动脉阻力增加。为了研究AWD和CHF中这种独特的出球小动脉反应性的潜在机制,在AWD、CHF和NC的单独分组中检测了肾小动脉对外源性血管紧张素II的反应。AWD和CHF组出球小动脉的血管收缩反应明显减弱(两组出球小动脉阻力的变化约为NC组的5%)。因此,在这两种情况下,维持GFR能力的损害至少部分归因于面对肾灌注压降低时出球小动脉反应的改变。(摘要截断于250字)

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