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地尔硫䓬和硝苯地平对大鼠肾脏血流动力学及肾小管对肾神经刺激反应的影响。

The influence of diltiazem and nifedipine on the haemodynamic and tubular responses of the rat kidney to renal nerve stimulation.

作者信息

Herod J J, Johns E J

出版信息

J Auton Pharmacol. 1985 Sep;5(3):251-60. doi: 10.1111/j.1474-8673.1985.tb00126.x.

Abstract

An investigation was undertaken in the pentobarbitone anaesthetized rat to determine the influence of calcium entry blockade on the haemodynamic and tubular responses of the kidney to renal sympathetic nerve stimulation. Electrical activation of the nerves, at rates causing a 12% reduction in renal blood flow, did not change glomerular filtration rate but significantly reduced urine flow (32%) and absolute (34%) and fractional sodium excretion (33%). Intravenous administration of diltiazem (10 and 20 micrograms/kg/min) and nifedipine (1.0 and 2.0 micrograms/kg/min) caused significant reductions of systemic blood pressure. Stimulation of the renal nerves, to reduce renal blood flow between 15% and 18% in the presence of both low and high doses of diltiazem, caused significant falls in glomerular filtration rate of 9% and 23%, respectively. During the low dose of nifedipine glomerular filtration rate did not change but in animals receiving the higher dose it fell by 17%. The magnitude of the neurally induced changes in urine flow, absolute and fractional sodium excretions were not different at either dose level of diltiazem or nifedipine from that observed in the absence of drugs. Stimulation of the renal nerves at low rates, which did not change renal blood flow, had no effect on glomerular filtration rate but significantly reduced urine flow (38%) and absolute (39%) and fractional sodium excretion (35%). At these low rates of nerve stimulation glomerular filtration rate remained unchanged during the infusion of either dose level of diltiazem. However, during administration of both the low and high doses of nifedipine there were significant reductions of glomerular filtration rate of 20% and 17%, respectively. The magnitude of the neurally induced changes in urine flow, absolute and fractional sodium excretions in the presence of both low and high doses of diltiazem and nifedipine were the same as those observed in the absence of drugs. The results of this study provide no evidence to indicate that the nerve mediated increases in tubular sodium reabsorption, a response involving alpha-adrenoreceptors, is dependent on the movement of calcium into the epithelial cells. The data did not indicate that blockade of calcium entry into cells impaired the ability of the kidney to regulate glomerular filtration rate which appeared to be due to a lack of renal efferent arteriolar vasoconstriction.

摘要

在戊巴比妥麻醉的大鼠身上进行了一项研究,以确定钙内流阻断对肾脏血流动力学和肾小管对肾交感神经刺激反应的影响。以导致肾血流量降低12%的速率对神经进行电刺激,并未改变肾小球滤过率,但显著降低了尿流量(32%)、绝对钠排泄量(34%)和分数钠排泄量(33%)。静脉注射地尔硫䓬(10和20微克/千克/分钟)和硝苯地平(1.0和2.0微克/千克/分钟)导致全身血压显著降低。在低剂量和高剂量地尔硫䓬存在的情况下,刺激肾神经使肾血流量减少15%至18%,分别导致肾小球滤过率显著下降9%和23%。在低剂量硝苯地平期间,肾小球滤过率未发生变化,但在接受高剂量的动物中,其下降了17%。在低剂量和高剂量地尔硫䓬或硝苯地平情况下,神经诱导的尿流量、绝对和分数钠排泄量变化幅度与未用药时观察到的情况无差异。以不改变肾血流量的低速率刺激肾神经,对肾小球滤过率无影响,但显著降低了尿流量(38%)、绝对钠排泄量(39%)和分数钠排泄量(35%)。在这些低速率神经刺激期间,输注任何剂量水平的地尔硫䓬时,肾小球滤过率均保持不变。然而,在给予低剂量和高剂量硝苯地平期间,肾小球滤过率分别显著降低了20%和17%。在低剂量和高剂量地尔硫䓬及硝苯地平存在的情况下,神经诱导的尿流量、绝对和分数钠排泄量变化幅度与未用药时观察到的情况相同。本研究结果没有证据表明神经介导的肾小管钠重吸收增加(一种涉及α-肾上腺素能受体的反应)依赖于钙进入上皮细胞的移动。数据并未表明钙进入细胞的阻断会损害肾脏调节肾小球滤过率的能力,这似乎是由于缺乏肾出球小动脉血管收缩所致。

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