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肾乳头暴露后尿渗透压降低机制的研究。

Studies on the mechanism of reduced urinary osmolality after exposure of renal papilla.

作者信息

Chuang E L, Reineck H J, Osgood R W, Kunau R T, Stein J H

出版信息

J Clin Invest. 1978 Mar;61(3):633-9. doi: 10.1172/JCI108974.

Abstract

Studies were performed in Munich-Wistar rats to determine whether changes in papillary plasma flow might be responsible for the concentrating defect which occurs after exposure of the extrarenal papilla. Papillary plasma flow was measured by (125)I-albumin accumulation. Initial studies in hydropenic animals revealed that papillary plasma flow was 40% higher in the kidney with the exposured papilla, 41 vs. 29 ml/min per 100 g of papilla (P < 0.001). This increase in papillary plasma flow was detectable 15 or 45 min after removing the ureter. Because it was unclear whether the rise in papillary plasma flow was a cause or the result of the fall in urine osmolality, similar studies were performed in animals undergoing a water diuresis. In this setting, papillary plasma flow still increased on the exposed side compared to the control side, 81 vs. 60 ml/min per 100 g, despite similarly low urine osmolalities of 155 and 174 mosmol/kg, respectively. This finding is compatible with the possibility that papillary exposure per se causes an increase in papillary plasma flow and that this hemodynamic alteration may lead to a reduction in urinary osmolality secondary to washout of the medullary interstitium. A final group of hydropenic rats was given either indomethacin or meclofenamate before removing the ureter. In these studies, there was no difference in either the papillary plasma flow or the urine osmolality between control and exposed kidneys. It is therefore suggested that opening the ureter induces an increase in papillary plasma flow by some mechanism which may involve an alteration in prostaglandin synthesis.

摘要

在慕尼黑-威斯塔大鼠身上进行了多项研究,以确定乳头血浆流量的变化是否可能是肾外乳头暴露后出现浓缩功能缺陷的原因。通过(125)I-白蛋白蓄积来测量乳头血浆流量。对禁水动物的初步研究表明,暴露乳头的肾脏中乳头血浆流量高出40%,每100克乳头分别为41毫升/分钟和29毫升/分钟(P<0.001)。在移除输尿管后15或45分钟即可检测到乳头血浆流量的这种增加。由于尚不清楚乳头血浆流量的增加是尿渗透压降低的原因还是结果,因此对处于水利尿状态的动物进行了类似研究。在这种情况下,尽管两侧尿渗透压同样较低,分别为155和174毫摩尔/千克,但暴露侧的乳头血浆流量仍比对照侧增加,每100克分别为81毫升/分钟和60毫升/分钟。这一发现符合以下可能性,即乳头暴露本身会导致乳头血浆流量增加,并且这种血流动力学改变可能导致髓质间质被冲洗后尿渗透压降低。最后一组禁水大鼠在移除输尿管前给予吲哚美辛或甲氯芬那酸。在这些研究中,对照肾和暴露肾之间的乳头血浆流量或尿渗透压均无差异。因此,提示输尿管开放通过某种可能涉及前列腺素合成改变的机制诱导乳头血浆流量增加。

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