Emmeluth C, Drummer C, Gerzer R, Bie P
Department of Medical Physiology, University of Copenhagen, Denmark.
Acta Physiol Scand. 1994 Jul;151(3):403-11. doi: 10.1111/j.1748-1716.1994.tb09760.x.
The renal response to a selective increase in the Na+ concentration of the blood perfusing the central nervous system was investigated in conscious dogs treated with the converting enzyme inhibitor enalaprilat and the aldosterone antagonist canrenoate. In split-infusion experiments the plasma [Na+] of carotid blood was increased (approx. 6 mM) by bilateral infusion of hypertonic NaC1. Concomitantly distilled water was infused into the v. cava making the sum of the infusions isotonic. In control experiments isotonic saline was infused at identical rates into all three catheters. Na+ excretion increased markedly in both series, 103 +/- 14 to 678 +/- 84 mumol min-1 during split-infusion and 90 +2- 14 to 496 +/- 74 mumol min-1 during the isotonic volume expansion. Peak rate of excretion, peak fractional sodium excretion, and cumulative sodium excretion were all significantly higher (P < 0.05) during split-infusion than during control experiments. Plasma vasopressin increased only during split-infusion (0.68 +/- 0.11 to 2.4 +/- 0.8 pg ml-1) while the increases in plasma atrial natriuretic peptide were similar in the two series. Urinary excretion of urodilatin (ANP95-126) increased significantly more during split-infusion (46 +/- 11 to 152 +/- 28 fmol min-1) than during the isotonic volume expansion (45 +/- 14 to 84 +/- 16 fmol min-1) (P < 0.05). It is concluded that the natriuretic mechanisms activated by a selective increase in the Na+ concentration of carotid blood and associated with increased excretion of urodilatin cannot be eliminated by blockade of the renin-angiotensin-aldosterone system.
在使用转化酶抑制剂依那普利拉和醛固酮拮抗剂坎利酸钾治疗的清醒犬中,研究了肾脏对灌注中枢神经系统血液中Na⁺浓度选择性升高的反应。在分侧输注实验中,通过双侧输注高渗NaCl使颈动脉血的血浆[Na⁺]升高(约6 mM)。同时,将蒸馏水输注到腔静脉中,使输注总量等渗。在对照实验中,以相同速率将等渗盐水输注到所有三根导管中。在两个系列中,Na⁺排泄均显著增加,分侧输注期间从103±14 μmol·min⁻¹增加到678±84 μmol·min⁻¹,等渗容量扩张期间从90±14 μmol·min⁻¹增加到496±74 μmol·min⁻¹。分侧输注期间的排泄峰值速率、峰值分数钠排泄和累积钠排泄均显著高于对照实验(P<0.05)。血浆血管加压素仅在分侧输注期间升高(从0.68±0.11 pg·ml⁻¹升高到2.4±0.8 pg·ml⁻¹),而两个系列中血浆心钠素的升高相似。分侧输注期间尿舒张素(ANP95 - 126)的排泄增加显著多于等渗容量扩张期间(从46±11 fmol·min⁻¹增加到152±28 fmol·min⁻¹,而等渗容量扩张期间从45±14 fmol·min⁻¹增加到84±16 fmol·min⁻¹)(P<0.05)。得出的结论是,由颈动脉血中Na⁺浓度选择性升高激活并与尿舒张素排泄增加相关的利钠机制不能通过阻断肾素 - 血管紧张素 - 醛固酮系统而消除。