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培哚普利抑制转换酶对原发性高血压患者肾血流动力学及利钠作用的影响

[The effects of inhibition of converting enzyme by perindopril on renal hemodynamics and natriuresis in essential arterial hypertension].

作者信息

Chaignon M, Barrou Z, Ayad M, Guédon J

机构信息

Service de néphrologie et hypertension artérielle, hôpital Foch, Suresnes.

出版信息

Arch Mal Coeur Vaiss. 1988 Jun;81 Spec No:151-4.

PMID:3142399
Abstract

Renal hemodynamics and natriuresis have been studied before and 6 hours after oral intake of perindopril (8 mg) in 8 hypertensive patients without renal failure. Then, the patients were treated with perindopril (8 mg per day) and renal hemodynamics was repeated on the fifth day, 6 hours after the morning intake of the substance. Sodium diet was controlled during the study (100 mmol sodium per day). Renal blood flow (RBF) and glomerular filtration rate (GFR) were measured by the clearance method using 131I-hippuran and 125I-iothalamate respectively. The results are as follows: (table; see text) Perindopril produced a potent renal vasodilatation after the first intake and the following days without any change in GFR. A significant decrease in FF was observed indicating that efferent as well as afferent arteriolar vasodilatation was induced. Perindopril produced an increase in natriuresis after the first intake and at D5; this natriuretic effect may be related to the changes in renal hemodynamics inducing a decreased sodium reabsorption in the proximal tubule.

摘要

在8例无肾衰竭的高血压患者中,研究了口服培哚普利(8毫克)前及服药后6小时的肾血流动力学和钠排泄情况。然后,患者接受培哚普利治疗(每日8毫克),并于服药后第5天早晨服药6小时后重复测量肾血流动力学。研究期间控制钠饮食(每日100毫摩尔钠)。分别使用131I - 马尿酸和125I - 碘肽酸盐通过清除率法测量肾血流量(RBF)和肾小球滤过率(GFR)。结果如下:(表格;见正文)首次服药后及随后几天,培哚普利引起显著的肾血管舒张,而GFR无任何变化。观察到滤过分数(FF)显著降低,表明入球小动脉和出球小动脉均发生了血管舒张。首次服药后及第5天,培哚普利使钠排泄增加;这种利钠作用可能与肾血流动力学变化有关,导致近端小管钠重吸收减少。

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