降钙素基因相关肽对肾病患者肾血流动力学及肾素和血管紧张素II分泌的急性影响。

Acute effects of calcitonin gene related peptide on renal haemodynamics and renin and angiotensin II secretion in patients with renal disease.

作者信息

Palla R, Parrini M, Panichi V, Andreini B, De Pietro S, Migliori M, Bianchi A M, Giovannini L, Bertelli A, Bertelli A A

机构信息

Institute of Medical Clinic II, University of Pisa, Italy.

出版信息

Int J Tissue React. 1995;17(1):43-9.

PMID:7499063

Abstract

The renal haemodynamic effects and renin-angiotensin II response to calcitonin gene-related peptide (CGRP) infusion were assessed in 16 patients with moderate hypertension and renal insufficiency. CGRP lowered the systemic mean blood pressure by 13% and increased the heart rate by 25%; the glomerular filtration rate rose from 56 +/- 11 ml/min to 71 +/- 8 ml/min (p < 0.005), the renal plasma flow decreased from 369 +/- 19 ml/min to 342 +/- 25 ml/min (p < 0.002) and the filtration fraction increased from 15 +/- 0.2% to 20 +/- 0.2%. Plasma renin activity rose stepwise during the CGRP infusion from 1.28 +/- 0.5 ng/ml/h to 1.66 +/- 0.4 and 1.89 +/- 0.4 ng/ml/h (p < 0.001). Angiotensin II showed a marked increase after 10 min of infusion (91.6 +/- 47.00 pg/ml) (control value 6.01 +/- 3.09 pg/ml) and at the end (28.63 +/- 16.00 pg/ml) (p < 0.001). CGRP exerts an apparently favourable effect on renal function of patients with renal insufficiency, but the observed increase of glomerular filtration rate is obtained by an increase of intraglomerular pressure secondary to angiotensin II production.

摘要

对16例中度高血压合并肾功能不全患者评估了降钙素基因相关肽（CGRP）输注对肾脏血流动力学的影响以及肾素 - 血管紧张素II反应。CGRP使体循环平均血压降低了13%，心率增加了25%；肾小球滤过率从56±11 ml/min升至71±8 ml/min（p<0.005），肾血浆流量从369±19 ml/min降至342±25 ml/min（p<0.002），滤过分数从15±0.2%增至20±0.2%。在CGRP输注期间，血浆肾素活性逐步升高，从1.28±0.5 ng/ml/h升至1.66±0.4 ng/ml/h和1.89±0.4 ng/ml/h（p<0.001）。输注10分钟后（91.6±47.00 pg/ml）（对照值6.01±3.09 pg/ml）及输注结束时（28.63±16.00 pg/ml）血管紧张素II显著升高（p<0.001）。CGRP对肾功能不全患者的肾功能有明显的有利作用，但观察到的肾小球滤过率增加是由血管紧张素II产生继发的肾小球内压升高所致。