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米非司酮诱导大鼠流产及败血症时的肾小球血流动力学

Glomerular hemodynamics during abortion induced by RU 486 and sepsis in rats.

作者信息

Boim M A, Draibe S A, Ramos O L, Ajzen H, Ulmann A, Schor N

机构信息

Disciplina de Nefrologia, Escola Paulista de Medicina, São Paulo, Brasil.

出版信息

Braz J Med Biol Res. 1994 Jun;27(6):1431-44.

PMID:7894359
Abstract
  1. Acute renal failure is a very common consequence of septic abortion. Whole kidney and glomerular hemodynamics were evaluated in virgin (V), pregnant (PREG) and aborted (ABOR) euvolemic Munich-Wistar rats before and after E. coli (0111-B4) endotoxin (LPS) infusion in order to evaluate the effect of septic abortion on the renal microcirculation. 2. Abortion induced by RU 486 blunted the increase in glomerular filtration rate (GFR) induced by normal pregnancy (0.86 +/- 0.03 vs 0.63 +/- 0.07 ml/min, P < 0.05). In virgin rats, RU 486 did not modify the parameters of renal function. Significant alterations occurred in whole kidney and single nephron function. However, the changes in whole kidney function in the ABOR group were significantly higher than those observed for the V group (reductions in GFR were 42% in V and 80% in ABOR, RPF decreased 34% in V and 76% in ABOR, TRVR increased 82% in V and 400% in ABOR). 3. Mean single nephron glomerular filtration rate (SNGFR) was reduced in all groups after LPS (44% in V, 43% in V+RU, 55% in PREG, 60% in ABOR), due to significant decreases in glomerular plasma flow rate, QA (42% in V, 55% in V+RU, 53% in PREG, 57% in ABOR) and in glomerular ultrafiltration coefficient, Kf (46% in V, 47% in V+RU, 45% in PREG, 67% in ABOR). 4. These data show that LPS induced significant alterations in renal function in all groups. However, aborted rats were more sensitive to the effects of LPS than V rats. These results indicate that abortion may potentiate the effects of endotoxemia on renal function elevating the extent of acute renal failure and thus the mortality rate.
摘要
  1. 急性肾衰竭是感染性流产非常常见的后果。为了评估感染性流产对肾微循环的影响,对未孕(V)、妊娠(PREG)和流产(ABOR)的血容量正常的慕尼黑-维斯塔尔大鼠在输注大肠杆菌(0111-B4)内毒素(LPS)前后的全肾和肾小球血流动力学进行了评估。2. RU 486诱导的流产减弱了正常妊娠诱导的肾小球滤过率(GFR)升高(0.86±0.03对0.63±0.07 ml/分钟,P<0.05)。在未孕大鼠中,RU 486未改变肾功能参数。全肾和单个肾单位功能发生了显著改变。然而,ABOR组全肾功能的变化显著高于V组(V组GFR降低42%,ABOR组降低80%;V组肾血浆流量(RPF)降低34%,ABOR组降低76%;V组肾小管-血管阻力(TRVR)升高82%,ABOR组升高400%)。3. LPS注射后所有组的平均单个肾单位肾小球滤过率(SNGFR)均降低(V组降低44%,V+RU组降低43%,PREG组降低55%,ABOR组降低60%),原因是肾小球血浆流速QA(V组降低42%,V+RU组降低55%,PREG组降低53%,ABOR组降低57%)和肾小球超滤系数Kf(V组降低46%,V+RU组降低47%,PREG组降低45%,ABOR组降低67%)显著下降。4. 这些数据表明,LPS在所有组中均引起了肾功能的显著改变。然而,流产大鼠比未孕大鼠对内毒素的作用更敏感。这些结果表明,流产可能增强内毒素血症对肾功能的影响,提高急性肾衰竭的程度,从而增加死亡率。

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