Bartter F C, Gill J R, Frolich J C, Bowden R E, Hollifield J W, Radfar N, Keiser H R, Oates J A, Seyberth H, Taylor A A
Trans Assoc Am Physicians. 1976;89:77-91.
In summary, the cardinal features of the syndrome of renal juxtaglomerular hyperplasia include overproduction of plasma renin activity, elevation of plasma angiotensin II concentration, elevation of aldosterone secretion and of plasma aldosterone concentration, hypokalemic alkalosis, and a resistance of arterioles to the pressor action of angiotensin II and norepinephrine. In the present studies, elevation of urinary PGE2 but not of PGF2alpha has been demonstrated. Inhibition of prostaglandin synthetase with indomethacin or ibuprofen has been shown to decrease plasma renin activity, and plasma aldosterone concentration and secretion rate, leading to a positive potassium balance and restoration of normal plasma potassium. The inhibitors decreased and glomerular filtration rate, and induced sodium retention. The results indicate that overproduction of PGE by the kidneys is a cardinal feature, but not necessary the primary one, in the pathogenesis of this syndrome.
总之，肾球旁增生综合征的主要特征包括血浆肾素活性过度产生、血浆血管紧张素II浓度升高、醛固酮分泌及血浆醛固酮浓度升高、低钾性碱中毒以及小动脉对血管紧张素II和去甲肾上腺素升压作用的抵抗。在本研究中，已证实尿中前列腺素E2升高，但前列腺素F2α未升高。已表明用消炎痛或布洛芬抑制前列腺素合成酶可降低血浆肾素活性、血浆醛固酮浓度及分泌率，导致钾平衡正向变化并使血浆钾恢复正常。这些抑制剂降低了肾小球滤过率并诱导了钠潴留。结果表明，肾脏前列腺素E过度产生是该综合征发病机制中的一个主要特征，但不一定是原发性特征。
