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甘油诱导的急性肾衰竭病理生理学的系列研究

Sequential studies on the pathophysiology of glycerol-induced acute renal failure.

作者信息

Reineck H J, O'Connor G J, Lifschitz M D, Stein J H

出版信息

J Lab Clin Med. 1980 Aug;96(2):356-62.

PMID:7400668
Abstract

The role of volume depletion and renal ischemia in the development of renal functional impairment in glycerol-induced ARF is not clear. This study was designed to evaluate the role of volume depletion in this model by determining the hemodynamic and functional alterations which occur between 3 and 18 hr after glycerol administration and the reversibility of these changes in response to Ringer loading. Three hours after glycerol, Cln and RBF, measured by flowmeter, were reduced 70% and 52%, respectively, in comparison with control values. FeNa was 0.04%. Ringer loading increased Clkn to 103% and RBF to 93% of control values. Qualitatively similar results were found 6 hr after glycerol. At 18 hr, Cln and RBF were 47% of control values. After Ringer loading, RBF rose to 100% of control. The response of Cln, however, was a function of the baseline FeNa. Cln incrased substantijally in rats with low FeNa but changed only slightly in animals in which this parameter was increased. These studies indicate that the early reduction in the Cln is dependent upon the fall in RBF. At 12 and 18 hr, however, the fall in Cln is not blood flow-dependent, and a second mechanism must be operative. FeNa seems to be a reliable index of the functional status of a given animal.

摘要

在甘油诱导的急性肾衰竭中,容量耗竭和肾缺血在肾功能损害发展过程中的作用尚不清楚。本研究旨在通过测定甘油给药后3至18小时之间发生的血流动力学和功能改变以及这些变化对林格液输注的反应可逆性,来评估容量耗竭在该模型中的作用。甘油给药3小时后,通过流量计测量的肌酐清除率(Cln)和肾血流量(RBF)与对照值相比分别降低了70%和52%。滤过钠排泄分数(FeNa)为0.04%。林格液输注使Cln增加到对照值的103%,RBF增加到对照值的93%。甘油给药6小时后发现了定性相似的结果。在18小时时,Cln和RBF为对照值的47%。林格液输注后,RBF升至对照值的100%。然而,Cln的反应是基线FeNa的函数。FeNa低的大鼠中Cln显著增加,但该参数升高的动物中Cln仅略有变化。这些研究表明,早期Cln的降低取决于RBF的下降。然而,在12和18小时时,Cln的下降不依赖于血流量,必然存在另一种机制。FeNa似乎是给定动物功能状态的可靠指标。

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