Waugh W H, Bales T E
Department of Physiology, East Carolina University School of Medicine, Greenville, North Carolina 27834.
Life Sci. 1988;42(15):1447-54. doi: 10.1016/0024-3205(88)90055-0.
To determine if indomethacin (indo) would attenuate the effects of changed renal perfusion pressure on sodium excretion as reported by others, we performed clearance studies in chloralose-anesthetized dogs without the major stress of laparotomy. Mean renal arterial pressure was varied by a balloon-tipped catheter indwelling the aorta suprarenally. With pressure decreases to mean values above 85 mm Hg during isotonic saline infusion, sodium output decreased only by 10.7 +/- 2.4% per 10 mm Hg pressure decrease without indo pre-treatment but decreased by 22.0 +/- 3.8% per 10 mm Hg pressure decrease with indo pre-treatment. The greater, rather than lesser, pressure effect on excretory function after indo in these experiments with chloralose anesthesia suggest that renal prostaglandin (PG) activity does not mediate normally pressure natriuresis. Instead, the data suggest that, in the absence of major stress, the renal pressure effects on excretory function may become more sensitive after indo. In addition, we postulate that the normal acute pressure natriuresis may be modest and may average no more than 20% change for each 10 mm Hg change in mean pressure above 90 mm Hg when stress is minimal and when vasoactive preglomerular autoregulation is nearly perfect. This is a phenomenon which keeps intrarenal tissue pressure and urine output relatively constant with arterial pressure elevations.
为了确定吲哚美辛(indo)是否会像其他人所报道的那样减弱肾灌注压变化对钠排泄的影响,我们在未进行剖腹术这种重大应激的水合氯醛麻醉犬身上进行了清除率研究。通过将带球囊导管置于肾上腺上方的主动脉中来改变平均肾动脉压。在输注等渗盐水期间,当压力降至平均高于85 mmHg时,在未进行indo预处理的情况下,每10 mmHg压力降低钠排出量仅减少10.7±2.4%,而在进行indo预处理后,每10 mmHg压力降低钠排出量减少22.0±3.8%。在这些水合氯醛麻醉实验中,indo处理后对排泄功能的压力影响更大而非更小,这表明肾前列腺素(PG)活性并非正常压力性利钠的介导因素。相反,数据表明,在没有重大应激的情况下,indo处理后肾压力对排泄功能的影响可能会变得更敏感。此外,我们推测,当应激最小且血管活性肾小球前自身调节近乎完美时,正常的急性压力性利钠作用可能较小,平均每10 mmHg平均压力变化超过90 mmHg时变化可能不超过20%。这是一种在动脉压升高时使肾内组织压力和尿量相对保持恒定的现象。