Mizuiri S, Hayashi I, Hirata K, Yamazaki J, Sasaki Y
Department of Nephrology, Toho University School of Medicine, Tokyo, Japan.
Am J Physiol Imaging. 1986;1(2):83-90.
With the purpose of studying the effect of exercise on renal function in hypertensive patients, renal dynamic studies were performed with the aid of 99mTc-diethylenetriamine pentaacetate (DTPA). Serial renal images were taken at rest and during bicycle ergometric stress in 14 hypertensive patients (H) and 14 normotensive controls (N). Renograms were constructed, and glomerular filtration rate was determined by the method of Gates [2]. Exercise resulted in a prolongation of peak time, an increase in radioisotope retention rate at 10 minutes (10-min counts/peak counts) on renograms, and a decrease of GFR in both H and N. Plasma renin activity, aldosterone, and catecholamines were all elevated during exercise in both H and N. Our data indicate that the exercise-induced renal dysfunction demonstrated by 99mTc-DTPA renograms is not specific to H but can also be observed in N, which may have resulted from changes common to H and N, as indicated by the change of GFR and humoral factors. These findings suggest that the renal response to exercise may be a more complex pathophysiologic process than that measured by the DTPA renogram, at least in its simplified form, and should encourage further work in this area in order to elucidate the underlying process of hypertension.
为研究运动对高血压患者肾功能的影响，借助99mTc-二乙三胺五乙酸（DTPA）进行了肾脏动态研究。对14例高血压患者（H组）和14例血压正常的对照者（N组）在静息状态及进行自行车测力计运动时拍摄了系列肾脏图像。绘制了肾图，并采用盖茨方法[2]测定了肾小球滤过率。运动导致H组和N组的峰值时间延长、肾图上10分钟时放射性同位素滞留率（10分钟计数/峰值计数）增加以及肾小球滤过率降低。运动期间，H组和N组的血浆肾素活性、醛固酮和儿茶酚胺均升高。我们的数据表明，99mTc-DTPA肾图显示的运动诱发的肾功能障碍并非高血压患者所特有，在血压正常的对照者中也可观察到，这可能是由肾小球滤过率和体液因子的变化所表明的H组和N组共有的变化导致的。这些发现提示，肾脏对运动的反应可能是一个比DTPA肾图所测量的更为复杂的病理生理过程，至少在其简化形式中如此，并且应该鼓励在该领域开展进一步的研究，以阐明高血压的潜在机制。
