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低血压性出血后的球管反馈反应

Tubuloglomerular feedback response after hypotensive hemorrhage.

作者信息

Kaufman J S, Hamburger R J, Flamenbaum W

出版信息

Ren Physiol. 1982;5(4):173-81. doi: 10.1159/000172854.

DOI:10.1159/000172854
PMID:7122981
Abstract

The tubuloglomerular feedback (TGF) response was studied in control rats and after either hypotensive hemorrhage or aortic clamping (AC). TGF was assessed both by differences in proximally and distally determined single nephron glomerular filtration rate (SNGFR) and by proximally determined SNGFR responses to orthograde microperfusion at 0 or 36 nl/min. Hypotensive hemorrhage was induced by the removal of blood equivalent to 0.5-1% of body weight. In control rats, proximal SNGFR was 29.74 +/- SE 0.87 nl/min and distal SNGFR was 28.64 +/- 0.82 nl/min, values not significantly different from each other. After moderate hemorrhagic hypotension (MH: BP = 86 +/- 1 mm Hg) or AC (BP = 70 +/- 4 mm Hg), both proximal and distal SNGFR decreased, with no significant differences between the values in either group. After severe hemorrhagic hypotension (SH; BP = 70 +/- 1 mm Hg), proximal SNGFR was 25.23 +/- 2.07 nl/min and distal SNGFR was 19.69 +/- 1.50 nl/min, values significantly different from each other and consistent with an enhanced feedback response. Using orthograde microperfusion, a significant reduction in SNGFR at a perfusion rate of 36 nl/min was observed under all circumstances. However, with SH hypotension the percent change in SNGFR at the two perfusion rates was significantly increased to 35.0 +/- 5.5%, compared to 21.6 +/- 6.6% in controls. In contrast, AC with reduction in renal perfusion pressure to a degree comparable to SH hypotension did not augment the relative decrease in SNGFR, the percentage change being 22.2 +/- 7.2%. Neither was TGF enhanced after MH hypotension when similar volumes of blood were removed but a similar decrease in BP was not obtained. These results suggest that some factor related to severe systemic hypotension enhanced the TGF response.

摘要

在对照大鼠以及低血压性出血或主动脉钳夹(AC)后,研究了肾小管 - 肾小球反馈(TGF)反应。通过近端和远端测定的单个肾单位肾小球滤过率(SNGFR)的差异以及近端测定的SNGFR对0或36 nl/min的顺行性微灌注的反应来评估TGF。通过去除相当于体重0.5 - 1%的血液诱导低血压性出血。在对照大鼠中,近端SNGFR为29.74±标准误0.87 nl/min,远端SNGFR为28.64±0.82 nl/min,两者值无显著差异。中度出血性低血压(MH:血压 = 86±1 mmHg)或AC(血压 = 70±4 mmHg)后,近端和远端SNGFR均降低,两组值之间无显著差异。严重出血性低血压(SH;血压 = 70±1 mmHg)后,近端SNGFR为25.23±2.07 nl/min,远端SNGFR为19.69±1.50 nl/min,两者值有显著差异,且与增强的反馈反应一致。使用顺行性微灌注,在所有情况下均观察到灌注率为36 nl/min时SNGFR显著降低。然而,与对照组的21.6±6.6%相比,SH低血压时两种灌注率下SNGFR的变化百分比显著增加至35.0±5.5%。相比之下,将肾灌注压降低至与SH低血压相当程度的AC并未增加SNGFR的相对降低,变化百分比为22.2±7.2%。当去除相似体积的血液但未获得相似程度的血压降低时,MH低血压后TGF也未增强。这些结果表明,与严重全身性低血压相关的某些因素增强了TGF反应。

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