肾神经和前列腺素在犬低血压性出血期间对肾血流动力学和血浆肾素活性的控制作用。

The role of renal nerves and prostaglandins in control of renal hemodynamics and plasma renin activity during hypotensive hemorrhage in the dog.

作者信息

Henrich W L, Anderson R J, Berns A S, McDonald K M, Paulsen P J, Berl T, Schrier R W

出版信息

J Clin Invest. 1978 Mar;61(3):744-50. doi: 10.1172/JCI108988.

DOI:10.1172/JCI108988

PMID:641152

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC372589/

Abstract

The effects of hypotensive hemorrhage (HH) on renal hemodynamics and plasma renin activity (PRA) during prostaglandin (PG) synthesis inhibition were examined in three groups of dogs. In each group of animals arterial blood pressure was lowered by a 30% decrement. In the first group of eight control animals, HH was not associated with a significant change in glomerular filtration rate (GFR, 42-36 ml/min, NS); renal blood flow (RBF) declined significantly, from 234 to 171 ml/min, P < 0.05. In the second group of eight animals, pretreated with RO 20-5720 (RO, 2 mg/kg), a competitive inhibitor of PG synthesis, HH was associated with a significant fall in GFR (43-17 ml/min, P < 0.001) and RBF (195-89 ml/min, P < 0.001). In the third group of eight animals, pretreatment with indomethacin (IN, 10 mg/kg), a chemically dissimilar PG inhibitor, HH was also associated with a significant fall in GFR (38-8 ml/min, P < 0.001) and RBF (150-30 ml/min, P < 0.001). Renal denervation attenuated this renal ischemic effect of HH in the presence of PG inhibition. In the RO group, GFR (34 vs. 17 ml/min, P < 0.005) and RBF (145 vs. 89 ml/min, P < 0.025) were significantly greater in denervated vs. innervated kidneys during HH. Similarly, in animals treated with IN, a significantly higher GFR (28 vs. 8 ml/min, P < 0.005) and RBF (101 vs. 30 ml/min, P < 0.005) occurred in denervated as compared to innervated kidneys during HH. With HH, the increase in PRA in the control group (3.34-11.68 ng/ml per h, P < 0.005) was no different than that observed in the RO group (4.96-18.9 ng/ml per h, P < 0.001) or IN group (4.71-17.8 ng/ml per h, P < 0.001). In summary, the present results indicate that renal PG significantly attenuate the effect of HH to decrease GFR and RBF. Furthermore, renal denervation exerts a protective effect against the enhanced renal ischemic effects which occur in the presence of PG inhibition during HH. Finally, PG inhibition does not alter the effect of HH to cause an increase in PRA.

摘要

在三组犬中研究了前列腺素（PG）合成抑制期间低血压性出血（HH）对肾血流动力学和血浆肾素活性（PRA）的影响。每组动物的动脉血压均降低30%。在第一组8只对照动物中，HH与肾小球滤过率（GFR，42 - 36 ml/min，无显著差异）的显著变化无关；肾血流量（RBF）显著下降，从234降至171 ml/min，P < 0.05。在第二组8只动物中，用PG合成的竞争性抑制剂RO 20 - 5720（RO，2 mg/kg）预处理后，HH与GFR（43 - 17 ml/min，P < 0.001）和RBF（195 - 89 ml/min，P < 0.001）的显著下降有关。在第三组8只动物中，用化学性质不同的PG抑制剂吲哚美辛（IN，10 mg/kg）预处理后，HH也与GFR（38 - 8 ml/min，P < 0.001）和RBF（150 - 30 ml/min，P < 0.001）的显著下降有关。肾去神经支配在PG抑制存在的情况下减弱了HH的这种肾缺血效应。在RO组中，HH期间去神经支配的肾脏与有神经支配的肾脏相比，GFR（34 vs. 17 ml/min，P < 0.005）和RBF（145 vs. 89 ml/min，P < 0.025）显著更高。同样，在接受IN治疗的动物中，HH期间去神经支配的肾脏与有神经支配的肾脏相比，GFR（28 vs. 8 ml/min，P < 0.005）和RBF（101 vs. 30 ml/min，P < 0.005）显著更高。HH时，对照组PRA的升高（3.34 - 11.68 ng/ml per h，P < 0.005）与RO组（4.96 - 18.9 ng/ml per h，P < 0.001）或IN组（4.71 - 17.8 ng/ml per h，P < 0.001）中观察到的升高没有差异。总之，目前的结果表明，肾PG显著减弱HH降低GFR和RBF的作用。此外，肾去神经支配对HH期间PG抑制存在时发生的增强的肾缺血效应具有保护作用。最后，PG抑制不会改变HH导致PRA升高的作用。