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β肾上腺素能刺激的抗利尿作用机制。

Mechanism of antidiuretic effect of beta adrenergic stimulation.

作者信息

Schrier R W, Lieberman R, Ufferman R C

出版信息

J Clin Invest. 1972 Jan;51(1):97-111. doi: 10.1172/JCI106803.

Abstract

The effect of beta adrenergic stimulation on renal-diluting capacity was examined in the dog. Beta adrenergic stimulation with intravenous isoproterenol significantly increased urinary osmolality (U(Osm)) and decreased free water clearance (C(H2O)), and these effects were rapidly reversible with cessation of the infusion. This antidiuretic effect of systemic beta adrenergic stimulation was comparable in innervated and denervated kidneys and was not associated with alterations in glomerular filtration rate or renal vascular resistance. Renal perfusion pressure was maintained constant in all of the experiments. The same dose of isoproterenol, which produced the antidiuretic effect and markedly stimulated cardiac beta adrenergic receptors when infused intravenously, was not found either to increase U(Osm) or to decrease C(H2O) when infused directly into the renal artery. Removal of the source of production and release of antidiuretic hormone (ADH) was, however, found to abolish the effect of intravenous isoproterenol on U(Osm). A small effect on C(H2O) persisted and appeared to be related to an increase in arterial hematocrit. Thus, the results of the study exclude a major role of alterations in renal hemodynamics and renal innervation in the antidiuretic response to beta adrenergic stimulation with isoproterenol. They also provide no support for the hypothesis that beta adrenergic stimulation may directly alter the water permeability of the renal tubular epithelium. Rather the results suggest that the primary mechanism of the antidiuretic effect of beta adrenergic stimulation involves the integrity of the hypothalamoneurohypophyial system and the release of ADH.

摘要

研究了β肾上腺素能刺激对犬肾脏稀释功能的影响。静脉注射异丙肾上腺素进行β肾上腺素能刺激可显著提高尿渗透压(U(Osm))并降低自由水清除率(C(H₂O)),且这些效应在停止输注后可迅速逆转。全身性β肾上腺素能刺激的这种抗利尿作用在有神经支配和去神经支配的肾脏中相当,且与肾小球滤过率或肾血管阻力的改变无关。在所有实验中,肾灌注压均保持恒定。当静脉输注时能产生抗利尿作用并显著刺激心脏β肾上腺素能受体的相同剂量异丙肾上腺素,直接注入肾动脉时未发现其能提高U(Osm)或降低C(H₂O)。然而,发现去除抗利尿激素(ADH)的产生和释放源可消除静脉注射异丙肾上腺素对U(Osm)的影响。对C(H₂O)仍有轻微影响,这似乎与动脉血细胞比容增加有关。因此,该研究结果排除了肾血流动力学改变和肾神经支配在对异丙肾上腺素β肾上腺素能刺激的抗利尿反应中的主要作用。它们也不支持β肾上腺素能刺激可能直接改变肾小管上皮水通透性这一假说。相反,结果表明β肾上腺素能刺激抗利尿作用的主要机制涉及下丘脑 - 神经垂体系统的完整性及ADH的释放。

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本文引用的文献

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J Physiol. 1967 Dec;193(3):513-22. doi: 10.1113/jphysiol.1967.sp008375.
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A study of the beta-adrenergic receptors in rat kidnevs.大鼠肾脏中β-肾上腺素能受体的研究。
Br J Pharmacol Chemother. 1963 Feb;20(1):135-8. doi: 10.1111/j.1476-5381.1963.tb01304.x.
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