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犬体内血管紧张素输注低于升压剂量、肾钠处理及盐诱导性高血压

Subpressor angiotensin infusion, renal sodium handling, and salt-induced hypertension in the dog.

作者信息

DeClue J W, Guyton A C, Cowley A W, Coleman T G, Norman R A, McCaa R E

出版信息

Circ Res. 1978 Oct;43(4):503-12. doi: 10.1161/01.res.43.4.503.

Abstract

We studied the combined effect of subpressor amounts of angiotensin and long-term sodium chloride infusion on arterial pressure in 16 dogs for periods of 2--8 weeks. In dogs receiving 3.5 liters of isotonic NaCl daily, but no angiotensin, the arterial pressure increased an average of only 3 mm Hg. When angiotensin was infused continuously at a rate of 5 ng/kg per min (a rate too small to cause an observable immediate increase in pressure, subsequent infusion of 3.5 liters of saline daily then increased the pressure by 39 mm Hg. The urinary output of sodium increased to the same extent in both instances, that is, there was no extra sodium loss because of the elevated pressure. This suggests that the angiotensin significantly blocked the normal "pressure natriuresis" usually seen with such large increases in pressure. However, the plasma aldosterone levels during angiotensin infusion were not found to be different from those in the absence of angiotensin. Therefore, we have suggested that the tendency of the kidneys to retain sodium under the influence of angiotensin was probably caused mainly by a direct effect of angiotensin on the kidney itself. Such a direct renal sodium-retaining effect also could be a contributing factor in the marked hypertension that results from salt administration in the presence of small amounts of angiotensin.

摘要

我们研究了低于升压剂量的血管紧张素与长期输注氯化钠对16只犬动脉血压的联合作用,观察期为2至8周。在每天接受3.5升等渗氯化钠但未接受血管紧张素的犬中,动脉血压平均仅升高3毫米汞柱。当以每分钟5纳克/千克的速率持续输注血管紧张素时(该速率过小,不足以引起可观察到的即时血压升高),随后每天输注3.5升生理盐水,则血压升高39毫米汞柱。两种情况下钠的尿量均有同等程度增加,也就是说,血压升高并未导致额外的钠流失。这表明血管紧张素显著阻断了通常在血压如此大幅升高时出现的正常“压力性利钠”现象。然而,并未发现输注血管紧张素期间的血浆醛固酮水平与未输注血管紧张素时有所不同。因此,我们认为在血管紧张素影响下肾脏保留钠的倾向可能主要是由血管紧张素对肾脏本身的直接作用所致。这种直接的肾脏保钠作用也可能是在存在少量血管紧张素的情况下因盐摄入导致显著高血压的一个促成因素。

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