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犬急性单侧肾切除术后的血流动力学和肾功能变化:颈动脉窦压力感受器的作用

Hemodynamic and renal functional changes after acute unilateral nephrectomy in the dog: role of carotid sinus baroreceptors.

作者信息

Ayus J C, Humphreys M H

出版信息

Am J Physiol. 1982 Feb;242(2):F181-9. doi: 10.1152/ajprenal.1982.242.2.F181.

Abstract

We examined the role of the carotid sinus baroreceptors in the hemodynamic and renal functional changes initiated by acute unilateral nephrectomy (AUN). In 15 anesthetized dogs, AUN caused increases in sodium (UNaV) and potassium excretion (UKV) without significant changes in GFR, renal blood flow, or mean arterial pressure. Cardiac output (CO) was measured in five of these animals and decreased from 2.5 +/- 0.2 to 1.9 +/- 0.3 liter/min as total peripheral resistance (TPR) increased. In 11 dogs with bilateral acute surgical carotid sinus denervation, AUN failed to cause any change in renal hemodynamics, UNaV, or UKV that could be distinguished from sham-operated time controls. CO was measured in seven of these dogs and also did not change. AUN caused an immediate, transient elevation in blood pressure that returned to control levels 15 min after nephrectomy. When bilateral carotid occlusion (BCO) was carried out prior to AUN in animals with intact carotid sinus baroreceptors, AUN again caused an immediate increase in blood pressure but no changes in CO or electrolyte excretion. In separate studies, AUN increased UNaV and UKV significantly; when BCO was then carried out after AUN, cation excretion remained elevated. In seven dogs undergoing continuous perfusion of the carotid circulation bilaterally at constant pressure, AUN again failed to increase cation excretion despite a 30 mmHg rise in arterial blood pressure. These studies demonstrate that AUN fails to initiate hemodynamic or compensatory renal functional changes in dogs with bilateral carotid sinus denervation or in animals in which intact baroreceptors are shielded from the systemic circulation by BCO or perfusion at constant pressure, indicating the importance of these baroreceptors in the early changes after AUN.

摘要

我们研究了颈动脉窦压力感受器在急性单侧肾切除(AUN)引发的血流动力学和肾功能变化中的作用。在15只麻醉犬中,AUN导致钠排泄量(UNaV)和钾排泄量(UKV)增加,而肾小球滤过率(GFR)、肾血流量或平均动脉压无显著变化。对其中5只动物测量了心输出量(CO),随着总外周阻力(TPR)增加,CO从2.5±0.2升/分钟降至1.9±0.3升/分钟。在11只双侧急性手术切除颈动脉窦神经的犬中,AUN未能引起肾血流动力学、UNaV或UKV的任何变化,这些变化与假手术时间对照组有明显区别。对其中7只犬测量了CO,其也未发生变化。AUN导致血压立即出现短暂升高,肾切除术后15分钟血压恢复至对照水平。在颈动脉窦压力感受器完整的动物中,在AUN之前进行双侧颈动脉闭塞(BCO)时,AUN再次导致血压立即升高,但CO或电解质排泄无变化。在单独的研究中,AUN显著增加了UNaV和UKV;在AUN之后进行BCO时,阳离子排泄仍保持升高。在7只双侧颈动脉循环持续恒压灌注的犬中,尽管动脉血压升高了30 mmHg,AUN再次未能增加阳离子排泄。这些研究表明,在双侧颈动脉窦去神经支配的犬中,或在通过BCO或恒压灌注使完整的压力感受器与体循环隔绝的动物中,AUN未能引发血流动力学或代偿性肾功能变化,这表明这些压力感受器在AUN后的早期变化中具有重要作用。

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