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人体在输注血管升压药期间肾脏类花生酸对肾脏血流动力学的调节作用。

Modulation of renal hemodynamics by renal eicosanoids during vasopressor infusions in man.

作者信息

Lebel M, Grose J H, Falardeau P

机构信息

Laval University Research Center, l'Hôtel-Dieu de Québec, Canada.

出版信息

Prostaglandins Leukot Essent Fatty Acids. 1989 Jan;35(1):41-9. doi: 10.1016/0952-3278(89)90015-x.

DOI:10.1016/0952-3278(89)90015-x
PMID:2928372
Abstract

Pressor doses of norepinephrine (NE) (n = 8) and angiotensin II (A II) (n = 5) were infused in normal volunteers to determine whether the systemic administration of vasopressor hormones influence renal eicosanoid production and whether, in turn, the eicosanoids produced could modulate renal hemodynamics and electrolyte excretion. At the doses administered, both pressor substances induced the expected rise in blood pressure, a significant decrease (P less than 0.05) in renal blood flow and a proportionally smaller fall in glomerular filtration rate, resulting in a consistent augmentation in filtration fraction. Fractional sodium excretion was concomitantly reduced. NE infusion produced only slight modifications in urinary prostaglandin (PG)E2, 2,3-dinor-6-keto-PGF1 alpha and thromboxane (TX)B2, while urinary 6-keto-PGF1 alpha and PGF2 alpha were increased by 38% and 176% respectively. The increase in urinary 6-keto-PGF1 alpha (the non-enzymatic degradation product of PGI2, predominantly of cortical origin) was proportional to the level of circulating NE (r = 0.78, P less than 0.05) and to the renal vascular resistance (r = 0.85, P less than 0.01), suggesting an immediate compensatory role for PGI2 in response to the NE-induced pressor stimulus. The renal production of PGE2 and PGF2 alpha (predominantly medullary) was inversely correlated with the filtration fraction: the greater the increase in PGE2 and PGF2 alpha the lower the elevation in filtration fraction or the decline in renal blood flow upon NE administration. All infusion variably stimulated the renal eicosanoid production: PGE2, 41%; PGF2 alpha, 102%; 6-keto-PGF1 alpha, 38%; 2,3-dinor-6-keto-PGF1 alpha, 38%; and TXB2, 25%.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

向正常志愿者输注升压剂量的去甲肾上腺素(NE)(n = 8)和血管紧张素II(A II)(n = 5),以确定全身性给予血管升压激素是否会影响肾脏类花生酸的产生,以及所产生的类花生酸是否反过来能调节肾脏血流动力学和电解质排泄。在所给予的剂量下,两种升压物质均引起预期的血压升高、肾血流量显著降低(P<0.05)以及肾小球滤过率成比例地较小下降,导致滤过分数持续增加。钠排泄分数随之降低。输注NE仅使尿前列腺素(PG)E2、2,3-二去甲-6-酮-PGF1α和血栓素(TX)B2发生轻微改变,而尿6-酮-PGF1α和PGF2α分别增加了38%和176%。尿6-酮-PGF1α(PGI2的非酶降解产物,主要来源于皮质)的增加与循环NE水平成正比(r = 0.78,P<0.05),并与肾血管阻力成正比(r = 0.85,P<0.01),提示PGI2对NE诱导的升压刺激有即时代偿作用。PGE2和PGF2α(主要来源于髓质)的肾脏产生与滤过分数呈负相关:NE给药后,PGE2和PGF2α增加越多,滤过分数升高越低或肾血流量下降越低。所有输注均不同程度地刺激了肾脏类花生酸的产生:PGE2为41%;PGF2α为102%;6-酮-PGF1α为38%;2,3-二去甲-6-酮-PGF1α为38%;TXB2为25%。(摘要截选至250字)

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