Agmon Y, Brezis M
Department of Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Exp Nephrol. 1993 Nov-Dec;1(6):357-63.
Nonsteroidal anti-inflammatory drugs (NSAIDs) predispose to acute and chronic renal failure, possibly due to intrarenal hemodynamic effects. In anesthetized volume-expanded rats, total renal blood flow (RBF) was measured by an ultrasonic flowmeter placed around the left renal artery, superficial cortical blood flow (sCBF) by a flunt laser-Doppler probe placed over the kidney surface, mid-cortical (mCBF) and outer medullary blood flow (oMBF) by a needle laser-Doppler probe inserted into the renal parenchyma. Indomethacin (5 mg/kg i.v.) caused no significant change in RBF (n = 9) or mCBF (n = 6) and slightly increased sCBF (to 106 +/- 2% of baseline; n = 8, p < 0.05). By contrast, oMBF dropped significantly (to 55 +/- 4% of baseline; n = 8, p < 0.0001) within 30 min of indomethacin administration. Similarly, acetylsalicylate (50 mg/kg i.v.) slightly increased sCBF (to 110 +/- 3% of baseline; n = 5, p < 0.05) but caused a significant drop in oMBF (to 54 +/- 2% of baseline; n = 5, p < 0.0001). These results suggest that NSAIDs cause a profound and selective reduction in oMBF which may predispose to acute or chronic intrarenal damage by aggravating medullary hypoxia.
非甾体抗炎药（NSAIDs）易导致急性和慢性肾衰竭，可能是由于其对肾内血流动力学的影响。在麻醉状态下血容量扩充的大鼠中，通过置于左肾动脉周围的超声流量计测量总肾血流量（RBF），通过置于肾表面的钝性激光多普勒探头测量浅表皮质血流量（sCBF），通过插入肾实质的针状激光多普勒探头测量皮质中层血流量（mCBF）和外髓血流量（oMBF）。吲哚美辛（5毫克/千克静脉注射）对RBF（n = 9）或mCBF（n = 6）无显著影响，sCBF略有增加（至基线的106±2%；n = 8，p < 0.05）。相比之下，吲哚美辛给药后30分钟内oMBF显著下降（至基线的55±4%；n = 8，p < 0.0001）。同样，乙酰水杨酸（50毫克/千克静脉注射）使sCBF略有增加（至基线的110±3%；n = 5，p < 0.05），但导致oMBF显著下降（至基线的54±2%；n = 5，p < 0.0001）。这些结果表明，NSAIDs会导致oMBF显著且选择性地降低，这可能通过加重髓质缺氧而易引发急性或慢性肾内损伤。
