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肾血流动力学对肾静脉压升高的反应:血管紧张素II的作用。

Renal hemodynamic responses to increased renal venous pressure: role of angiotensin II.

作者信息

Kastner P R, Hall J E, Guyton A C

出版信息

Am J Physiol. 1982 Sep;243(3):F260-4. doi: 10.1152/ajprenal.1982.243.3.F260.

Abstract

Studies were performed to quantitate the effects of progressive increases in renal venous pressure (RVP) on renin secretion (RS) and renal hemodynamics. RVP was raised in 10 mmHg increments to 50 mmHg. Renin secretion rate increased modestly as RVP was increased to 30 mmHg and then increased sharply after RVP exceeded 30 mmHg. Glomerular filtration rate (GFR), renal blood flow (RBF), and filtration fraction (FF) did not change significantly when RVP was elevated to 50 mmHg. GFR and RBF were also measured after the renin-angiotension system (RAS) was blocked with the angiotensin converting enzyme inhibitor (CEI) SQ 14225. After a 60-min CEI infusion, RBF was elevated (32%), GFR was unchanged, FF was decreased, and total renal resistance (TRR) was decreased. As RVP was increased to 50 mmHg, GFR and FF decreased to 36.3 and 40.0% of control, respectively, RBF returned to a value not significantly different from control, and TRR decreased to 44.8% of control. The data indicate that the RAS plays an important role in preventing reductions in GFR during increased RVP because blockade of angiotensin II (ANG II) formation by the CEI results in marked decreases in GFR at high RVPs. The decreases in GFR after ANG II blockade and RVP elevation were not due to lack of renal vasodilation, since TRR was maintained below while RBF was maintained either above or at the pre-CEI levels.

摘要

开展了多项研究以定量评估肾静脉压力(RVP)逐步升高对肾素分泌(RS)和肾血流动力学的影响。RVP以10 mmHg的增幅升高至50 mmHg。随着RVP升高至30 mmHg,肾素分泌率适度增加,而当RVP超过30 mmHg后则急剧增加。当RVP升高至50 mmHg时,肾小球滤过率(GFR)、肾血流量(RBF)和滤过分数(FF)均无显著变化。在用血管紧张素转换酶抑制剂(CEI)SQ 14225阻断肾素 - 血管紧张素系统(RAS)后,也对GFR和RBF进行了测量。在输注CEI 60分钟后,RBF升高(32%),GFR未变,FF降低,总肾阻力(TRR)降低。当RVP升高至50 mmHg时,GFR和FF分别降至对照值的36.3%和40.0%,RBF恢复至与对照无显著差异的值,TRR降至对照值的44.8%。数据表明,RAS在RVP升高期间防止GFR降低方面发挥重要作用,因为CEI阻断血管紧张素II(ANG II)形成会导致高RVP时GFR显著降低。ANG II阻断和RVP升高后GFR的降低并非由于肾血管舒张不足,因为TRR维持在较低水平,而RBF维持在CEI输注前水平之上或与之相当。

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