Uhari M, Tarkka M, Koskinen M
Pediatr Cardiol. 1986;7(2):83-7. doi: 10.1007/BF02328956.
Renal perfusion and the effectiveness of antihypertensive therapy were evaluated in experimental coarctation. A sham operation was performed at the age of two months on one group of dogs (n = 5); coarctation of the thoracic aorta was produced at the same age in a second group (n = 7) which was not treated with antihypertensive drugs; and coarctation was similarly produced in a third group (n = 6) which was treated with antihypertensive drugs; the drug treatment was begun one month after the coarctation operation. After operation, all dogs were observed for seven months under similar circumstances. With high doses of antihypertensive agents (hydrochlorothiazide 25 mg/day, propranolol 80 mg/day, and prazosin 20 mg/day), the blood pressure decreased significantly in the coarctation with treatment group compared with the coarctation without treatment group. Renal perfusion, when measured by xenon-133 washout at the age of five months, was similar in the coarctation without drug treatment and control groups but significantly lower (23% decrease, p less than 0.01) in the coarctation with drug treatment group; renal perfusion was similar in all three groups when measured at the ages of eight and nine months. The observed temporary decrease suggests a need to evaluate renal perfusion during antihypertensive treatment in coarctation in man.
在实验性主动脉缩窄模型中评估了肾灌注及降压治疗的效果。一组犬(n = 5)在2月龄时进行假手术;第二组(n = 7)在相同年龄制作胸主动脉缩窄模型,且未接受降压药物治疗;第三组(n = 6)同样制作胸主动脉缩窄模型并接受降压药物治疗,药物治疗在缩窄手术后1个月开始。术后,所有犬在相似条件下观察7个月。使用高剂量降压药(氢氯噻嗪25mg/天、普萘洛尔80mg/天和哌唑嗪20mg/天)时,与未治疗的主动脉缩窄组相比,治疗组的血压显著降低。在5月龄时通过氙-133洗脱法测量肾灌注,未接受药物治疗的主动脉缩窄组和对照组相似,但药物治疗的主动脉缩窄组显著降低(降低23%,p<0.01);在8月龄和9月龄测量时,三组的肾灌注相似。观察到的暂时降低提示有必要在人类主动脉缩窄的降压治疗期间评估肾灌注。