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一氧化氮和前列环素在实验性肝硬化肾灌注控制中的作用

Role of nitric oxide and prostacyclin in the control of renal perfusion in experimental cirrhosis.

作者信息

Ros J, Clària J, Jiménez W, Bosch-Marcé M, Angeli P, Arroyo V, Rivera F, Rodés J

机构信息

Hormonal Laboratory, Hospital Clínic i Provincial, University of Barcelona, Spain.

出版信息

Hepatology. 1995 Sep;22(3):915-20.

PMID:7657300
Abstract

Nitric oxide (NO) and prostacyclin (PGI2) are two important modulators of renal function under normal conditions; however, little is known on their contributory role in cirrhosis with ascites. In this study, mean arterial pressure, renal hemodynamics, and sodium excretion were measured in 15 rats with cirrhosis and ascites and 16 control rats. Animals were studied in normal conditions, after inhibiting the synthesis of NO (N omega-nitro-L-arginine, 50 micrograms.kg-1.min-1) or prostaglandins (lysin acetylsalicylate, 15 mg.kg-1).min-1 and following the concomitant inhibition of both systems. Cirrhotic rats showed increased systemic pressure sensitivity and blunted renal vasoconstrictor response to nitric oxide inhibition as compared with control rats. As a consequence, the glomerular filtration rate increased in cirrhotic rats but not in control rats. In both groups of animals, NO inhibition was associated with significant increased urinary sodium and fractional sodium excretion. The only significant effect observed after prostaglandin biosynthesis inhibition was a decrease in renal plasma flow in cirrhotic rats. The concomitant inhibition of both systems reduced renal plasma flow and did not change glomerular filtration rate, with no differences between control and cirrhotic rats. Prostaglandin inhibition did not prevent the natriuretic effect of the NO inhibitor in both groups of animals. These results indicate that in experimental cirrhosis both NO and PGI2 play an important role in the maintenance of renal perfusion within normal limits.

摘要

一氧化氮(NO)和前列环素(PGI2)是正常情况下肾功能的两种重要调节因子;然而,它们在肝硬化腹水患者中的作用尚不清楚。在本研究中,对15只肝硬化腹水大鼠和16只对照大鼠测量了平均动脉压、肾血流动力学和钠排泄。在正常条件下、抑制NO合成(Nω-硝基-L-精氨酸,50微克·千克-1·分钟-1)或前列腺素合成(赖氨匹林,15毫克·千克-1·分钟-1)后以及同时抑制这两种系统后对动物进行研究。与对照大鼠相比,肝硬化大鼠表现出全身压力敏感性增加,对NO抑制的肾血管收缩反应减弱。因此,肝硬化大鼠的肾小球滤过率增加,而对照大鼠则没有。在两组动物中,抑制NO均与尿钠和钠排泄分数显著增加有关。抑制前列腺素生物合成后观察到的唯一显著影响是肝硬化大鼠肾血浆流量减少。同时抑制这两种系统会降低肾血浆流量,但不会改变肾小球滤过率,对照大鼠和肝硬化大鼠之间没有差异。抑制前列腺素并不能阻止两组动物中NO抑制剂的利钠作用。这些结果表明,在实验性肝硬化中,NO和PGI2在将肾灌注维持在正常范围内均起重要作用。

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