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心血管和肾脏对慢性血管加压素输注的反应。

Cardiovascular and renal responses to chronic vasopressin infusion.

作者信息

Brown A J, Lohmeier T E, Carroll R G, Meydrech E F

出版信息

Am J Physiol. 1986 Apr;250(4 Pt 2):H584-94. doi: 10.1152/ajpheart.1986.250.4.H584.

DOI:10.1152/ajpheart.1986.250.4.H584
PMID:3515969
Abstract

Arginine vasopressin (AVP) was infused into the renal artery of seven uninephrectomized conscious dogs at successive rates of 0.09, 0.36, and 1.46 ng X kg-1 X min-1 for 18, 9, and 5 days, respectively; subsequently, the nonpressor analogue of AVP, 1-desamino-8-D-arginine vasopressin (DDAVP), was infused intrarenally for 7 additional days. The lowest infusion rate of AVP produced a high concentration of AVP in the renal circulation (maximal antidiuresis) with only a relatively moderate increase in peripheral plasma AVP concentration. For comparison, the effects of a comparable increase in peripheral plasma AVP concentration during intravenous infusion at this same rate were observed in an additional group of dogs. Acutely, when this low dose of AVP was infused either intrarenally or intravenously, there was marked antidiuresis, but there were no significant changes in mean arterial pressure (MAP), renal hemodynamics, or urinary electrolyte excretion. Chronically, in both groups of animals, cumulative water balance was positive, and glomerular filtration rate, effective renal plasma flow, and MAP (16-18 mmHg) all increased; plasma renin activity decreased. Similar changes were observed during DDAVP infusion. When elevated peripheral plasma levels of AVP were achieved during the higher infusion rates of AVP, natriuresis and diuresis occurred, but, otherwise there was little change in the above variables, including MAP. Thus the hydrosmotic effects of AVP appear to account for its moderate hypertensive activity. Further, the failure of AVP to produce prominent hypertension, even when pronounced systemic vasoconstrictor effects are manifested, may be a result of its inability to promote significant renal vasoconstriction and antinatriuresis.

摘要

将精氨酸加压素(AVP)以0.09、0.36和1.46 ng·kg⁻¹·min⁻¹的连续速率分别注入7只单侧肾切除的清醒犬的肾动脉,持续18、9和5天;随后,将AVP的非加压类似物1-去氨基-8-D-精氨酸加压素(DDAVP)肾内注入7天。AVP的最低输注速率在肾循环中产生了高浓度的AVP(最大抗利尿作用),而外周血浆AVP浓度仅相对适度增加。为作比较,在另一组犬中观察了以相同速率静脉输注期间外周血浆AVP浓度类似增加的效应。急性情况下,当以低剂量AVP肾内或静脉内输注时,出现明显的抗利尿作用,但平均动脉压(MAP)、肾血流动力学或尿电解质排泄无显著变化。长期来看,两组动物的累积水平衡均为正值,肾小球滤过率、有效肾血浆流量和MAP(升高16 - 18 mmHg)均增加;血浆肾素活性降低。在DDAVP输注期间观察到类似变化。当在较高输注速率的AVP期间外周血浆AVP水平升高时,出现利钠和利尿作用,但除此之外,上述变量(包括MAP)几乎没有变化。因此,AVP的水渗透性效应似乎解释了其适度的高血压活性。此外,即使表现出明显的全身血管收缩效应,AVP未能产生显著高血压可能是由于其无法促进显著的肾血管收缩和抗利钠作用。

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