Conger J D, Falk S A, Gillum D M
Department of Medicine, University of Colorado, Health Sciences Center, Denver.
Am J Kidney Dis. 1989 Mar;13(3):217-25. doi: 10.1016/s0272-6386(89)80055-1.
Selective thyroidectomy (Tx) has been shown to attenuate proteinuria and disease progression in models of chronic renal failure (CRF). In this investigation, four groups of Munich-Wistar rats were studied to determine if glomerular dynamics or another renal metabolic consequence of Tx was responsible for the protective effect as measured by 24-hour protein excretion (UPROT). The groups were TxT4, thyroxine-replaced Tx rats with five-sixths nephrectomy; Tx, Tx rats not receiving replacement thyroxine with five-sixths nephrectomy; TxI, Tx rats not receiving replacement thyroxine with five-sixths nephrectomy that were given continuous intraperitoneal isoproterenol to restore systemic and renal hemodynamics; and TxT4(C), two-kidney Tx rats receiving replacement thyroxine that served as normal controls. Five-sixths nephrectomy was carried out 2 weeks after Tx, and experiments were carried out 1 week later. Serum T4 was profoundly reduced and there was failure to gain weight in Tx and TxI rats, despite similar protein intakes in all groups. Cardiac output was reduced in Tx, but was similar in TxI to levels in TxT4 rats. Whole-kidney glomerular filtration rate was lower in Tx, at 0.145 +/- 0.052 mL/min (P less than 0.05), but similar in TxI (0.305 +/- 0.147 mL/min) to that in TxT4 rats (0.317 +/- 0.135 mL/min). Twenty-four-hour urinary protein, which was 129 +/- 57 mg in TxT4, was reduced in Tx to 9 +/- 3 mg (P less than 0.01) but restored in TxI to 89 +/- 30 mg, a level similar to that in TxT4.(ABSTRACT TRUNCATED AT 250 WORDS)
在慢性肾衰竭（CRF）模型中，选择性甲状腺切除术（Tx）已被证明可减轻蛋白尿并延缓疾病进展。在本研究中，对四组慕尼黑-威斯塔大鼠进行了研究，以确定Tx对肾小球动力学的影响或Tx的其他肾脏代谢后果是否是24小时尿蛋白排泄量（UPROT）所衡量的保护作用的原因。这四组分别为：TxT4组，即行五分之六肾切除术后接受甲状腺素替代治疗的Tx大鼠；Tx组，即行五分之六肾切除术后未接受甲状腺素替代治疗的Tx大鼠；TxI组，即行五分之六肾切除术后未接受甲状腺素替代治疗但给予持续腹腔注射异丙肾上腺素以恢复全身和肾脏血流动力学的Tx大鼠；以及TxT4（C）组，即接受甲状腺素替代治疗的双肾Tx大鼠，作为正常对照。Tx术后2周进行五分之六肾切除术，1周后开展实验。尽管所有组的蛋白质摄入量相似，但Tx组和TxI组大鼠的血清T4显著降低且体重未增加。Tx组的心输出量降低，但TxI组的心输出量与TxT4组的水平相似。Tx组的全肾肾小球滤过率较低，为0.145±0.052 mL/分钟（P<0.05），而TxI组（0.305±0.147 mL/分钟）与TxT4组（0.317±0.135 mL/分钟）相似。TxT4组的24小时尿蛋白为129±57毫克，Tx组降至9±3毫克（P<0.01），但TxI组恢复至89±30毫克，与TxT4组水平相似。（摘要截断于250字）
