Katholi R E, Naftilan A J, Bishop S P, Oparil S
Hypertension. 1983 Jul-Aug;5(4):427-35. doi: 10.1161/01.hyp.5.4.427.
We previously observed that the renal nerves facilitate sodium retention and contribute to the development of DOCA-salt hypertension in the rat. To determine whether the renal nerves also participate in the maintenance of DOCA-salt hypertension, we studied the effects of renal denervation after 3 or 10 weeks of DOCA-salt treatment on systolic blood pressure, urinary sodium excretion, creatinine clearance, and precapillary arteriolar wall/lumen ratios of renal, hindlimb muscle, and cremaster muscle vascular beds. Systolic blood pressures of animals given DOCA-salt reached a plateau by 3 weeks of treatment at which time a sham operation or renal denervation was performed. Sham operation in hypertensive animals resulted in no change in systolic blood pressure and no change in percent sodium intake excreted. Wall/lumen ratio of the renal precapillary arteriole in sham-operated hypertensive animals was increased compared to similar sized vessels in hindlimb and cremaster muscle. In contrast, renal denervation resulted in a natriuresis and an attenuation of the hypertension (208 +/- 7 mmHg; p less than 0.01). Wall/lumen ratio of the renal capillary arterioles in renal denervated animals was no different than similar sized vessels in hindlimb and cremaster muscle and significantly less than that seen in sham-operated animals (0.85 +/- 0.05 vs 1.03 +/- 0.06; p less than 0.05). In another group of animals, sham operation or renal denervation was performed after 10 weeks of DOCA-salt treatment. At this time neither operation altered systolic blood pressure or sodium balance. In contrast to 3-week DOCA-salt-treated hypertensive sham-operated animals, renal precapillary arteriolar wall/lumen ratio of 10-week animals was no different than similar sized vessels in hindlimb and cremaster muscle. In addition, renal precapillary arteriolar wall/lumen ratio of 10-week DOCA-salt-treated renal-denervated animals was no different than that seen in 10-week DOCA-salt-treated sham-operated hypertensive animals. Creatinine clearance of the 10-week DOCA-salt-treated sham-operated or renal-denervated animals was significantly (p less than 0.01) lower than that of the 3-week DOCA-salt-treated groups (0.25 +/- 0.14 vs 1.03 +/- 0.10 ml/min). These data suggest that the renal nerves contribute to the early established phase of DOCA-salt hypertension by shifting the arterial pressure-renal sodium excretion curve to the right. With time, the renal nerves play a diminishing role in the maintenance of established DOCA-salt hypertension in the rat, while other renal factors, including decreased glomerular filtration rate and probable fixed renal vascular changes, play an increasingly important role.
我们之前观察到肾神经促进钠潴留,并在大鼠去氧皮质酮-盐性高血压的发展中起作用。为了确定肾神经是否也参与去氧皮质酮-盐性高血压的维持,我们研究了在去氧皮质酮-盐治疗3周或10周后进行肾去神经支配对收缩压、尿钠排泄、肌酐清除率以及肾、后肢肌肉和提睾肌血管床的毛细血管前小动脉壁/腔比值的影响。给予去氧皮质酮-盐的动物在治疗3周时收缩压达到平台期,此时进行假手术或肾去神经支配。高血压动物的假手术对收缩压无影响,钠摄入排泄百分比也无变化。与后肢和提睾肌中类似大小的血管相比,假手术的高血压动物肾毛细血管前小动脉的壁/腔比值增加。相比之下,肾去神经支配导致利钠作用和高血压的减轻(208±7 mmHg;p<0.01)。肾去神经支配动物的肾毛细血管前小动脉壁/腔比值与后肢和提睾肌中类似大小的血管无差异,且显著低于假手术动物(0.85±0.05对1.03±0.06;p<0.05)。在另一组动物中,在去氧皮质酮-盐治疗10周后进行假手术或肾去神经支配。此时,两种手术均未改变收缩压或钠平衡。与3周去氧皮质酮-盐治疗的高血压假手术动物不同,10周动物的肾毛细血管前小动脉壁/腔比值与后肢和提睾肌中类似大小的血管无差异。此外,10周去氧皮质酮-盐治疗的肾去神经支配动物的肾毛细血管前小动脉壁/腔比值与10周去氧皮质酮-盐治疗的假手术高血压动物无差异。10周去氧皮质酮-盐治疗的假手术或肾去神经支配动物的肌酐清除率显著低于3周去氧皮质酮-盐治疗组(0.25±0.14对1.03±0.10 ml/min;p<0.01)。这些数据表明,肾神经通过将动脉压-肾钠排泄曲线向右移动,促成去氧皮质酮-盐性高血压的早期阶段。随着时间推移,肾神经在大鼠已建立的去氧皮质酮-盐性高血压维持中所起的作用逐渐减弱,而其他肾因素,包括肾小球滤过率降低和可能的固定肾血管变化,发挥着越来越重要的作用。