Blantz R C, Pelayo J C
Fed Proc. 1983 Nov;42(14):3071-4.
Investigations in which a variety of experimental approaches were used, i.e., micropuncture techniques, analysis of intrarenal hormonal receptor, and electron microscopic analysis of renal morphology, have substantiated a major role for angiotensin II (AII) within the kidney in the regulation of vascular resistances, glomerular function, and even tubular reabsorption. It is also clear that AII exerts a significant influence on glomerular hemodynamics in a variety of altered physiological and pathophysiological states. Recent studies suggest a rather complex interaction between AII and hormonal and adrenergic effects at the glomerular level. AII may also play an important functional role in the pathogenesis of certain forms of acute renal failure. The specific mechanism whereby AII decreases the glomerular ultrafiltration coefficient, however, remains to be fully elucidated. Although in vitro and in vivo studies have suggested that the glomerular effects of AII may be associated with contraction of glomerular mesangial cells, recent in vivo quantitative evaluation has suggested that a uniform vasoconstriction of glomerular capillaries with proportional reductions in glomerular surface area is probably not the sole mechanism for the AII-induced reductions in glomerular ultrafiltration coefficient.
采用了多种实验方法进行的研究,即微穿刺技术、肾内激素受体分析以及肾脏形态的电子显微镜分析,证实了血管紧张素II(AII)在肾脏内对血管阻力、肾小球功能乃至肾小管重吸收的调节中起主要作用。同样清楚的是,AII在多种改变的生理和病理生理状态下对肾小球血流动力学有显著影响。最近的研究表明,AII与肾小球水平的激素和肾上腺素能效应之间存在相当复杂的相互作用。AII在某些形式的急性肾衰竭的发病机制中也可能起重要的功能作用。然而,AII降低肾小球超滤系数的具体机制仍有待充分阐明。尽管体外和体内研究表明AII对肾小球的作用可能与肾小球系膜细胞收缩有关,但最近的体内定量评估表明,肾小球毛细血管均匀收缩并伴有肾小球表面积成比例减少可能不是AII诱导肾小球超滤系数降低的唯一机制。