Favre L, Williams G, Favre H, Paunier L, Vallotton M B
Miner Electrolyte Metab. 1985;11(3):186-91.
The relationship between renal prostaglandins (PG) and electrolyte transport in the thick ascending limb of Henle's loop (TALH) was examined in 8 normal subjects and in 7 patients with hypokalemia, the latter including 4 cases of Bartter's syndrome. Distal fractional delivery and distal reabsorption of chloride and sodium were determined using clearance techniques under maximal volume expansion, and urinary excretion rates of PGE2 and PGF2 alpha were measured. In the normal subjects, suppression of PG synthesis by indomethacin decreased distal delivery without changing distal reabsorption, suggesting that PG may influence solute transport at a site proximal to the diluting segment. In the subjects with Bartter's syndrome, however, distal reabsorption was impaired, this defect being apparently independent of PG as it was unaffected by inhibition of PG synthesis. In the patients with hypokalemia due to non-renal causes, distal reabsorption of chloride was increased, resulting in a decreased chloride clearance. These results suggest a link between renal PG and solute transport in normal man and also provide evidence that Bartter's syndrome is characterized by a prostaglandin-independent defect in distal reabsorption which is not found in hypokalemia due to other causes.
在8名正常受试者和7名低钾血症患者（其中包括4例巴特综合征患者）中，研究了肾前列腺素（PG）与亨氏袢升支粗段（TALH）中电解质转运之间的关系。在最大容量扩张情况下，使用清除技术测定氯和钠的远端分数排泄和远端重吸收，并测量PGE2和PGF2α的尿排泄率。在正常受试者中，吲哚美辛抑制PG合成会降低远端排泄，而不改变远端重吸收，这表明PG可能在稀释段近端的部位影响溶质转运。然而，在巴特综合征患者中，远端重吸收受损，该缺陷显然与PG无关，因为它不受PG合成抑制的影响。在非肾性原因导致低钾血症的患者中，氯的远端重吸收增加，导致氯清除率降低。这些结果表明正常人体内肾PG与溶质转运之间存在联系，也提供了证据表明巴特综合征的特征是远端重吸收存在前列腺素非依赖性缺陷，而在其他原因导致的低钾血症中未发现这种缺陷。
