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犬对四小时胆道梗阻的肾脏反应。

Renal response to four hours of biliary obstruction in the dog.

作者信息

Levy M, Finestone H

出版信息

Am J Physiol. 1983 May;244(5):F516-25. doi: 10.1152/ajprenal.1983.244.5.F516.

Abstract

Clearance studies were performed in anesthetized dogs before and 4 h after the acute obstruction of the common bile duct (ABDL). ABDL was not associated with any change in systemic hemodynamics or plasma volume. Glomerular filtration rate (GFR) rose by 15.3%, PAH clearance by 13.3%, and renal blood flow by 13% (all values significant at P less than 0.05). Fractional excretion rates of water and sodium rose from 0.29 to 1.1 and from 0.21 to 0.76%, respectively (P less than 0.05). These changes in renal function were associated with a failure of bile excretion rather than distension of the biliary tree or failure of bile to enter the duodenum. They did not depend on intact hepatic nerves, alteration of hepatic perfusion, or the release of gastrointestinal vasoactive peptides. The increment in renal perfusion was maintained for 2-3 days before returning to baseline levels. Several lines of evidence suggested that factors influencing the renal tubule and the renal microcirculation might be separate in nature: e.g., urinary sodium excretion (UNaV) could increase without a change in GFR; if ABDL was relieved, delta UNaV and delta GFR returned to base line with different time courses; and controlling perfusion to the left kidney during ABDL reduced but did not abolish the increase in UNaV. Both effects could be transferred to recipient dogs by cross-perfusion. We have demonstrated, therefore, that 4 h of ABDL may significantly influence renal function through the appearance of humoral factors in the circulation.

摘要

在胆总管急性梗阻(ABDL)前及梗阻后4小时,对麻醉犬进行了清除率研究。ABDL与全身血流动力学或血浆容量的任何变化均无关联。肾小球滤过率(GFR)升高了15.3%,对氨基马尿酸清除率升高了13.3%,肾血流量升高了13%(所有数值在P小于0.05时具有显著性)。水和钠的分数排泄率分别从0.29%升至1.1%和从0.21%升至0.76%(P小于0.05)。肾功能的这些变化与胆汁排泄失败有关,而非胆管树扩张或胆汁未能进入十二指肠。它们不依赖于完整的肝神经、肝灌注改变或胃肠道血管活性肽的释放。肾灌注增加在恢复至基线水平之前维持2 - 3天。几条证据表明,影响肾小管和肾微循环的因素在性质上可能是分开的:例如,尿钠排泄(UNaV)可在GFR无变化的情况下增加;如果ABDL解除,ΔUNaV和ΔGFR会以不同的时间进程恢复至基线;在ABDL期间控制左肾灌注可降低但不能消除UNaV的增加。两种效应均可通过交叉灌注传递给受体犬。因此,我们已经证明,ABDL 4小时可能通过循环中体液因子的出现显著影响肾功能。

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