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出血及再输血对犬肾内血流分布的影响。

Effect of hemorrhage and retransfusion on intrarenal distribution of blood flow in dogs.

作者信息

Aukland K, Wolgast M

出版信息

J Clin Invest. 1968 Mar;47(3):488-501. doi: 10.1172/JCI105745.

Abstract

Distribution of intrarenal blood flow was studied in 12 dogs anesthetized with Nembutal. Medullary blood flow was estimated by local clearance of hydrogen gas from the outer medulla measured polarographically with needleshaped platinum electrodes, and by local clearance of (85)Kr and mean transit time of (32)P-labeled erythrocytes measured with a small semiconductor detector placed in the outer medulla. Cortical blood flow was estimated from cortical red cell transit time and from total renal blood flow measured by electromagnetic flowmeter. Bleeding to a mean arterial pressure of 50-65 mm Hg in the course of 8-20 min reduced cortical and medullary blood flow on the average to the same extent. In half of the experiments both cortical and medullary blood flow were reduced proportionately less than mean arterial pressure during the first half hour of bleeding. Maintenance of mean arterial pressure at 50-65 mm Hg in all cases led to progressive reduction of both cortical and medullary blood flow, out of proportion to the reduction of arterial pressure. A two step bleeding procedure used in two experiments also led to uniform reduction of renal blood flow. Reinfusion of blood after 2-3 hr of hypotension increased total renal blood flow to an average of 82% and outer medullary hydrogen clearance to an average of 92% of control values. All dogs survived the experiment without evidence of renal failure. It is concluded that hemorrhagic hypotension in dogs leads to a progressive and fairly uniform rise in renal vascular resistance, without any selective hemodynamic response in the juxtamedullary circulation.

摘要

在12只戊巴比妥麻醉的犬中研究了肾内血流分布。用针状铂电极极谱法测量外髓氢气的局部清除率,并用置于外髓的小型半导体探测器测量(85)氪的局部清除率和(32)磷标记红细胞的平均通过时间来估计髓质血流。根据皮质红细胞通过时间和用电磁流量计测量的总肾血流来估计皮质血流。在8 - 20分钟内将平均动脉血压降至50 - 65毫米汞柱,平均使皮质和髓质血流减少程度相同。在一半的实验中,在出血的前半小时,皮质和髓质血流减少的比例均小于平均动脉血压。在所有情况下将平均动脉血压维持在50 - 65毫米汞柱会导致皮质和髓质血流逐渐减少,且与动脉血压降低不成比例。在两个实验中采用的两步放血程序也导致肾血流均匀减少。低血压2 - 3小时后回输血液使总肾血流平均增加到对照值的82%,外髓氢气清除率平均增加到对照值的92%。所有犬均存活至实验结束,无肾衰竭迹象。结论是犬失血性低血压导致肾血管阻力逐渐且相当均匀地升高,近髓循环无任何选择性血流动力学反应。

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引用本文的文献

本文引用的文献

1
THE RENAL CIRCULATION IN SHOCK.休克时的肾循环
J Clin Invest. 1944 May;23(3):381-402. doi: 10.1172/JCI101506.
2
Studies of the renal circulation.肾循环的研究。
Circulation. 1950 Mar;1(3):445-53. doi: 10.1161/01.cir.1.3.445.
4
Effects of hypoxia on renal tubular function.缺氧对肾小管功能的影响。
J Appl Physiol. 1952 Jan;4(7):593-601. doi: 10.1152/jappl.1952.4.7.593.
6
Evidence against renal hypoxia in acute haemorrhagic shock.急性失血性休克中肾脏缺氧的反证
Pflugers Arch Gesamte Physiol Menschen Tiere. 1962;274:356-63. doi: 10.1007/BF00363077.
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INTRARENAL DISTRIBUTION OF BLOOD FLOW.肾内血流分布
Am J Physiol. 1965 Jun;208:1107-13. doi: 10.1152/ajplegacy.1965.208.6.1107.

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