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正常和糖尿病大鼠对泛影酸盐的肾血流动力学反应。

The renal hemodynamic response to diatrizoate in normal and diabetic rats.

作者信息

Reed J R, Williams R H, Luke R G

出版信息

Invest Radiol. 1983 Nov-Dec;18(6):536-40. doi: 10.1097/00004424-198311000-00011.

DOI:10.1097/00004424-198311000-00011
PMID:6417044
Abstract

To study the renal hemodynamic response to a large intravenous bolus of a radiocontrast agent, 8 ml/kg body weight of 60% diatrizoate meglumine (D-60) was infused over 30 seconds in both normal rats and rats with streptozotocin-induced diabetes. The effect of equiosmolar mannitol (1350 mOsm/kg) was compared with the D-60 response in normal rats to examine the potential role of hypertonicity in mediating a response. A similar two-phase response was seen in all three groups. The effect of D-60 in normal rats was similar to that of mannitol, but all responses were reduced in diabetic rats. During Phase I in normal rats in response to D-60 there was a transient three-minute reduction in blood pressure (BP), and renal blood flow (RBF) fell by 62 +/- 7%. During Phase II blood pressure did not change from normal baseline values, but RBF fell by 29 +/- 5%; GFR fell by 42 +/- 3%, and filtration fraction (FF) diminished. In diabetic rats baseline FF was lower than normal and was not further reduced after infusion of D-60. It is suggested that D-60 reduces RBF and GFR by a nonspecific osmotic effect, perhaps related to tubuloglomerular feedback or to an acute increase in intratubular pressure. Responses to these mechanisms may be reduced in diabetic rats with a chronic glycosuric osmotic diuresis.

摘要

为研究静脉大剂量注射造影剂后肾脏的血流动力学反应,对正常大鼠和链脲佐菌素诱导的糖尿病大鼠均在30秒内静脉注射8毫升/千克体重的60%泛影葡胺(D - 60)。将等渗甘露醇(1350毫渗量/千克)的作用与正常大鼠中D - 60的反应进行比较,以研究高渗性在介导反应中的潜在作用。所有三组均观察到类似的双相反应。D - 60对正常大鼠的作用与甘露醇相似,但糖尿病大鼠的所有反应均减弱。在正常大鼠中,静脉注射D - 60后第一阶段,血压(BP)短暂下降三分钟,肾血流量(RBF)下降62±7%。在第二阶段,血压未偏离正常基线值,但RBF下降29±5%;肾小球滤过率(GFR)下降42±3%,滤过分数(FF)降低。糖尿病大鼠的基线滤过分数低于正常水平,注射D - 60后未进一步降低。提示D - 60通过非特异性渗透作用降低RBF和GFR,这可能与肾小管 - 肾小球反馈或肾小管内压力急性升高有关。患有慢性糖尿渗透性利尿的糖尿病大鼠对这些机制的反应可能减弱。

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引用本文的文献

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Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies.造影剂所致肾病:发病机制、危险因素及预防策略。
CMAJ. 2005 May 24;172(11):1461-71. doi: 10.1503/cmaj.1040847.
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The role of endothelin in radiocontrast nephropathy.内皮素在放射性造影剂肾病中的作用。
Int Urol Nephrol. 1997;29(5):609-13. doi: 10.1007/BF02552209.
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Acute renal failure with selective medullary injury in the rat.大鼠急性肾衰竭伴选择性髓质损伤
J Clin Invest. 1988 Aug;82(2):401-12. doi: 10.1172/JCI113612.