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容量耗竭在急性肾衰竭甘油模型中的作用。

Role of volume depletion in the glycerol model of acute renal failure.

作者信息

Cushner H M, Barnes J L, Stein J H, Reineck H J

出版信息

Am J Physiol. 1986 Feb;250(2 Pt 2):F315-21. doi: 10.1152/ajprenal.1986.250.2.F315.

DOI:10.1152/ajprenal.1986.250.2.F315
PMID:3946607
Abstract

Previous studies have demonstrated significant volume depletion early in the course of glycerol-induced acute renal failure. In addition, it has been shown that acute volume expansion within 6 h of glycerol administration reverses the fall in inulin clearance but volume expansion 12-24 h after glycerol fails to restore that parameter to normal. The current studies were performed to determine whether chronic volume expansion would prevent the fall in inulin clearance normally observed 18-20 h after the insult. Inulin clearance was therefore compared 18-20 h after glycerol in hydropenic rats and in rats undergoing chronic volume expansion by the constant infusion of Ringer solution at a rate of 5 ml/h initiated at the time of the glycerol injection. Inulin clearance was well maintained in the latter group, averaging 1.77 compared with 0.22 ml/min in the hydropenic group. Renal histology revealed no difference in the degree of tubular necrosis between groups but did show a marked decrease in cast formation in the animals undergoing chronic volume expansion. To determine the possible significance of these casts, micropuncture studies were carried out to measure proximal tubular pressures. Under hydropenic conditions these pressures were not different control animals and rats receiving glycerol when studied 18-20 h after glycerol. Following acute volume expansion, however, glycerol-treated rats demonstrated significantly higher pressures than control rats. On the other hand, proximal tubular pressures were comparable in glycerol-treated and control animals receiving the chronic volume expansion.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

以往研究表明,甘油诱导的急性肾衰竭病程早期存在显著的容量耗竭。此外,研究还显示,甘油给药后6小时内进行急性容量扩充可逆转菊粉清除率的下降,但甘油给药后12 - 24小时进行容量扩充则无法使该参数恢复正常。进行当前研究以确定慢性容量扩充是否能预防损伤后18 - 20小时通常出现的菊粉清除率下降。因此,对禁水大鼠以及在甘油注射时开始以5毫升/小时的速率持续输注林格液进行慢性容量扩充的大鼠,在甘油给药后18 - 20小时比较菊粉清除率。后一组的菊粉清除率得到良好维持,平均为1.77,而禁水组为0.22毫升/分钟。肾脏组织学检查显示两组间肾小管坏死程度无差异,但慢性容量扩充的动物管型形成明显减少。为确定这些管型的可能意义,进行了微穿刺研究以测量近端肾小管压力。在禁水条件下,甘油给药后18 - 20小时进行研究时,这些压力与对照动物及接受甘油的大鼠无差异。然而,急性容量扩充后,甘油处理的大鼠显示出比对照大鼠显著更高的压力。另一方面,接受慢性容量扩充的甘油处理动物和对照动物的近端肾小管压力相当。(摘要截短于250字)

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