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实验性糖尿病中肾血流自动调节的定量评估

A quantitative assessment of renal blood flow autoregulation in experimental diabetes.

作者信息

De Micheli A G, Forster H, Duncan R C, Epstein M

机构信息

Nephrology Section, Veterans Administration Medical Center, Miami, Fla 33125.

出版信息

Nephron. 1994;68(2):245-51. doi: 10.1159/000188265.

Abstract

Several approaches have been utilized to describe renal blood flow (RBF) autoregulation in normal and pathological conditions. When describing the relation between RBF and stepwise decrements in renal perfusion pressure (RPP), these methods have several limitations, including: the necessity for predetermining a pressure 'break-point', and establishing constraints on changes in flow. To circumvent these limitations, we successfully utilized a third order polynomial, the cubical parabola, to characterize the autoregulatory responses in untreated streptozotocin (STZ) diabetic and control rats. The nonlinear relationship occurring between RBF and RPP was estimated from individual observations using the equation RBF = a + b x 10(-6) (RPP-c)3. Variables a and c represent RBF and RPP at the inflection point of the curve, respectively; variable b represents the rate of fall of RBF as RPP decreases (shape factor). Variable c was significantly lower in the diabetic group than in the control group whereas variable b was greater in the diabetic group. RBF (a) did not differ between the two groups. In conclusion, we determined that the range of RBF autoregulation in untreated diabetic rats is reset to a lower RPP. Furthermore, the curve below the inflection point declines more rapidly in diabetic rats than in controls. We propose that the equation described herein constitutes a promising and reproducible method for describing RBF autoregulation in vivo.

摘要

已有多种方法用于描述正常和病理状态下的肾血流量(RBF)自动调节。在描述RBF与肾灌注压(RPP)逐步降低之间的关系时,这些方法存在一些局限性,包括:需要预先确定压力“断点”,以及对血流变化设定限制。为了克服这些局限性,我们成功地利用三次多项式(立方抛物线)来表征未治疗的链脲佐菌素(STZ)糖尿病大鼠和对照大鼠的自动调节反应。使用方程RBF = a + b x 10(-6) (RPP - c)3,根据个体观察值估计RBF与RPP之间的非线性关系。变量a和c分别代表曲线拐点处的RBF和RPP;变量b代表随着RPP降低RBF的下降速率(形状因子)。糖尿病组的变量c显著低于对照组,而糖尿病组的变量b更大。两组之间的RBF(a)没有差异。总之,我们确定未治疗的糖尿病大鼠中RBF自动调节的范围被重置为较低的RPP。此外,糖尿病大鼠中拐点以下的曲线下降速度比对照组更快。我们认为本文所述的方程构成了一种有前景且可重复的体内描述RBF自动调节的方法。

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