吲哚美辛对镰状细胞肾病患者肾脏浓缩和稀释功能的影响。

The influence of indomethacin on renal concentrating and diluting capacity in sickle cell nephropathy.

De Jong P E, De Jong-van den Berg L T, De Zeeuw D, Donker A J, Schouten H, Statius van Eps L W

Clin Sci (Lond). 1982 Jul;63(1):53-8. doi: 10.1042/cs0630053.

Abstract

The effects of indomethacin on water excretion during both vasopressin stimulation and inhibition were studied in control subjects and in patients with sickle cell anaemia. 2. In the control group as well as in the group of patients with sickle cell anaemia sodium and urea retention occurred after indomethacin in the water-depleted state. During water loading, indomethacin induced sodium retention without urea reabsorption. 3. In healthy volunteers indomethacin increased urinary osmolality during water deprivation, but not after water loading. In contrast, in patients with sickle cell anaemia indomethacin caused a rise in urinary osmolality during water loading, but not after deprivation. 4. The findings support the view that indomethacin promotes solute reabsorption in the distal tubule. 5. From our observations we conclude that renal prostaglandins are not involved in the urinary concentrating defect of patients with sickle cell anaemia. On the other hand, the normal diluting capacity in sickle cell anaemia appears to depend on renal prostaglandins.

摘要

研究了消炎痛在血管加压素刺激和抑制过程中对水排泄的影响，研究对象为健康对照者和镰状细胞贫血患者。2. 在对照组以及镰状细胞贫血患者组中，处于缺水状态时，消炎痛会导致钠和尿素潴留。在水负荷状态下，消炎痛会引起钠潴留但不会导致尿素重吸收。3. 在健康志愿者中，缺水时消炎痛会增加尿渗透压，但水负荷后不会。相反，在镰状细胞贫血患者中，水负荷时消炎痛会导致尿渗透压升高，但缺水后不会。4. 这些发现支持了消炎痛促进远曲小管溶质重吸收的观点。5. 根据我们的观察，我们得出结论：肾前列腺素不参与镰状细胞贫血患者的尿浓缩功能缺陷。另一方面，镰状细胞贫血患者正常的稀释能力似乎依赖于肾前列腺素。