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新生豚鼠慢性部分输尿管梗阻。II. 影响肾小球滤过率的压力梯度

Chronic partial ureteral obstruction in the neonatal guinea pig. II. Pressure gradients affecting glomerular filtration rate.

作者信息

Chevalier R L

出版信息

Pediatr Res. 1984 Dec;18(12):1271-7. doi: 10.1203/00006450-198412000-00009.

Abstract

Neonatal guinea pigs with chronic partial ureteral obstruction (CPUO) and contralateral nephrectomy develop hydroureteronephrosis and reduced glomerular filtration rate (GFR) without significant reduction of renal blood flow. To investigate the role of pressure gradients in determination of GFR, micropuncture studies were performed in animals 23 +/- 3 days of age subjected to left ureteral constriction and right nephrectomy within the first 2 days of life and compared to uninephrectomized controls. Resulting ureteral dilatation was variable, with kidney weight and ureteral diameter being proportional to the rise in ureteral pressure (PU). In individual animals with severe CPUO (ureteral diameter greater than or equal to 3 mm), distal tubular transit time was either normal (31-90 s) or prolonged (greater than 120 s). Superficial single nephron GFR (SNGFR) was inversely correlated with PU. Glomerular capillary pressure and afferent arteriolar colloid oncotic pressure were not affected by CPUO while peritubular capillary, proximal and distal intratubular hydrostatic pressure increased as a function of PU. As a result, afferent effective filtration pressure (EFPA) was reduced in severe (10.0 +/- 1.1 mm Hg) compared to mild CPUO (13.4 +/- 0.5 mm Hg), but was not different from controls (11.3 +/- 0.9 mm Hg). For both control and CPUO groups, superficial SNGFR increased by 0.5 nl/min for each mm Hg increase in EFPA but for a given EFPA, SNGFR was 6 nl/min lower in guinea pigs with CPUO. These results indicate that higher EFPA in animals with mild compared to severe CPUO contributes to maintenance of higher SNGFR.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

患有慢性部分输尿管梗阻(CPUO)并接受对侧肾切除术的新生豚鼠会出现肾盂积水和肾小球滤过率(GFR)降低,而肾血流量无显著减少。为了研究压力梯度在GFR测定中的作用,对出生后前两天内接受左输尿管结扎和右肾切除术、年龄为23±3天的动物进行了微穿刺研究,并与未进行肾切除术的对照组进行比较。由此产生的输尿管扩张程度各不相同,肾脏重量和输尿管直径与输尿管压力(PU)的升高成正比。在患有严重CPUO(输尿管直径大于或等于3毫米)的个体动物中,远端肾小管转运时间正常(31 - 90秒)或延长(大于120秒)。浅表单肾单位GFR(SNGFR)与PU呈负相关。肾小球毛细血管压力和入球小动脉胶体渗透压不受CPUO影响,而肾小管周围毛细血管、近端和远端肾小管内静水压力随PU升高而增加。结果,与轻度CPUO(13.4±0.5毫米汞柱)相比,严重CPUO时入球有效滤过压(EFPA)降低(10.0±1.1毫米汞柱),但与对照组(11.3±0.9毫米汞柱)无差异。对于对照组和CPUO组,EFPA每升高1毫米汞柱,浅表SNGFR增加0.5纳升/分钟,但对于给定的EFPA,患有CPUO的豚鼠的SNGFR低6纳升/分钟。这些结果表明,与严重CPUO的动物相比,轻度CPUO动物中较高的EFPA有助于维持较高的SNGFR。(摘要截断于250字)

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