Bernardi P, Ghezzi F, Bastagli L, Grimaldi R, Cavazza M, Minelli C, Fontana F, Clo' C, Ventura C, Capelli M
Prostaglandins Leukot Med. 1986 May;22(2):235-48. doi: 10.1016/0262-1746(86)90092-2.
The effects of polyunsaturated fatty acids (phosphatidylcholine) on renal function in healthy subjects and in patients with chronic renal failure, with liver cirrhosis, and with heart failure were studied. The drug was administered at 3.5 mg/kg i.v. (Linoleic acid 1.24 mg/kg). In all cases, the administration of the drug caused an increased excretion of sodium and especially of water with a reduction in basal urinary hypertonicity. The polyuria was caused by the higher glomerular filtration rate not being counterbalanced by an increase in tubular water reabsorption. The water reabsorption was mostly anisosmotic. The presence of urinary hypertonicity excluded an inhibition of ADH secretion by this drug. The sodium excretion was probably caused by an increase of the glomerular filtration rate whereas no significant changes in the tubular reabsorption of sodium were seen. We found a significant (p 0.05) increase in PGE2 urinary excretion after phosphatidylcholine administration. Lysine - acetylsalicylate injection after phosphatidylcholine, in other trials in the same patients, prevented the effects previously reported. Therefore we suggest that the effects of this drug are mediated by an increased availability of renal prostaglandins.
研究了多不饱和脂肪酸(磷脂酰胆碱)对健康受试者以及慢性肾功能衰竭、肝硬化和心力衰竭患者肾功能的影响。药物以3.5mg/kg静脉注射给药(亚油酸1.24mg/kg)。在所有病例中,给药后钠尤其是水的排泄增加,基础尿高渗性降低。多尿是由于较高的肾小球滤过率未被肾小管水重吸收增加所抵消。水重吸收大多是非等渗的。尿高渗性的存在排除了该药物对抗利尿激素分泌的抑制作用。钠排泄可能是由于肾小球滤过率增加所致,而肾小管对钠的重吸收未见明显变化。我们发现给予磷脂酰胆碱后尿中前列腺素E2排泄显著增加(p<0.05)。在同一患者的其他试验中,给予磷脂酰胆碱后注射赖氨酸-乙酰水杨酸可预防先前报道的效应。因此我们认为该药物的作用是由肾脏前列腺素可用性增加介导的。