Janssen B J, Eerdmans P H, Smits J F
Department of Pharmacology, Cardiovascular Research Institute Maastricht, University of Limburg, Maastricht, The Netherlands.
Naunyn Schmiedebergs Arch Pharmacol. 1994 May;349(5):528-37. doi: 10.1007/BF00169143.
Regional hemodynamics following intravenous injection of furosemide were studied in conscious rats instrumented with Doppler flowprobes. Furosemide caused a dose-dependent acute (within 3 min) transient increase in renal resistance (RR) followed by a later generalized vasoconstriction in the renal, mesenteric and hindquarter (HQR) vascular bed. With in vitro experiments a possible direct effect of furosemide on renal artery segments was excluded. The acute rise in RR was partly (approximately 40%) attenuated by pretreatment with phentolamine or prazosin, but not prevented by renal denervation, volume repletion or pretreatment with captopril, losartan, indomethacin, aminophylline, nifedipine, or a vasopressin V1A-receptor-antagonist. However, the acute renal vasoconstriction was absent in water diuretic rats. The later vasoconstriction was blunted by captopril (RR+HQR), losartan (RR) and phentolamine (HQR) pretreatment. We conclude that the later generalized vasoconstriction following furosemide involves regional specific stimulation of angiotensin II and alpha-adrenoceptors. The mechanism of the acute renal vasoconstriction could not be fully determined. Because of its absence in water diuretic rats, its rapid onset, transient nature and relative insensitivity for pharmacological tools in euvolemic rats, the acute increase in RR following furosemide may be caused by cell swelling as a result from dissipation of the renal medullary gradient.
在使用多普勒血流探头的清醒大鼠中研究了静脉注射呋塞米后的局部血流动力学。呋塞米导致肾阻力(RR)出现剂量依赖性急性(3分钟内)短暂增加,随后在肾、肠系膜和后肢(HQR)血管床出现后期全身性血管收缩。通过体外实验排除了呋塞米对肾动脉段可能的直接作用。酚妥拉明或哌唑嗪预处理可部分(约40%)减轻RR的急性升高,但肾去神经支配、补充血容量或卡托普利、氯沙坦、吲哚美辛、氨茶碱、硝苯地平或血管加压素V1A受体拮抗剂预处理均不能阻止其升高。然而,水利尿大鼠不存在急性肾血管收缩。卡托普利(RR + HQR)、氯沙坦(RR)和酚妥拉明(HQR)预处理可减弱后期血管收缩。我们得出结论,呋塞米后出现的后期全身性血管收缩涉及血管紧张素II和α - 肾上腺素能受体的局部特异性刺激。急性肾血管收缩的机制尚不能完全确定。由于其在水利尿大鼠中不存在、起效迅速、具有短暂性且对正常血容量大鼠的药理学工具相对不敏感,呋塞米后RR的急性升高可能是由于肾髓质梯度消散导致细胞肿胀引起的。