Papanicolaou N, Papadakis G, Papanicolaou P, Theodorakopoulos P, Paris M, Dontas A, Paris M, Bariety J, Milliez P
Prostaglandins Med. 1981 Aug;7(2):163-81. doi: 10.1016/0161-4630(81)90060-4.
Mean blood pressure (MBP) was found to be lower, while renal plasma flow (RPF), glomerular filtration rats (GFR), sodium excretion rate (U(Na)V), potassium excretion rate (U(k)V) and urinary prostaglandin E (PGE) concentration were higher in 15 normotensive subjects (15NS) compared with the values obtained in 15 essential hypertensive patients (15EHP) of the same mean age. After volume expansion of the 15HP with isotonic saline infusion, RPF, U(Na)V, U(k)V, urine volume (UV) and urinary PGE increased significantly while plasma renin activity (PRA) decreased significantly. Urinary aldosterone concentration and MBP decreased also but not significantly. After oral administration of 75 mg of indomethacin, in the same loaded group of 15 EHP, urinary PGE, urinary aldosterone and PRA decreased significantly while RPF, GRF, U(Na)V remained unaltered and MBP increased. When these values obtained in saline loaded and indomethacin treated 15EHP were compared to those obtained in the same group before volume expansion, it was found that RPF, U(NaV, U(k)V and UV were higher after indomethacin-saline administration while MBP, GRF and urinary PGE did not differ significantly and PRA and urinary aldosterone were significantly lower. These findings argue against the suggestion that PGE increases sodium reabsorption at the distal tubule and indicate that the unaltered sodium excretion rate in saline loaded and indomethacin treated unanaesthetized subjects, results from the simultaneous decrease of renomedullary PGE, Renin and aldosterone secretion.
研究发现，15名血压正常受试者（15NS）的平均血压（MBP）较低，而肾血浆流量（RPF）、肾小球滤过率（GFR）、钠排泄率（U(Na)V）、钾排泄率（U(k)V）和尿前列腺素E（PGE）浓度高于15名年龄均值相同的原发性高血压患者（15EHP）。对15名原发性高血压患者静脉输注等渗盐水进行扩容后，RPF、U(Na)V、U(k)V、尿量（UV）和尿PGE显著增加，而血浆肾素活性（PRA）显著降低。尿醛固酮浓度和MBP也下降，但不显著。在同一组15名原发性高血压患者口服75mg吲哚美辛后，尿PGE、尿醛固酮和PRA显著降低，而RPF、GFR、U(Na)V保持不变，MBP升高。将盐水扩容和吲哚美辛治疗的15名原发性高血压患者的这些值与扩容前同一组患者的值进行比较时，发现吲哚美辛-盐水给药后RPF、U(Na)V、U(k)V和UV较高，而MBP、GFR和尿PGE无显著差异，PRA和尿醛固酮显著较低。这些发现与PGE增加远端小管钠重吸收的观点相悖，表明在盐水扩容和吲哚美辛治疗的未麻醉受试者中，钠排泄率未改变是由于肾髓质PGE、肾素和醛固酮分泌同时减少所致。
