Sandin R, Feuk U, Modig J
Department of Anaesthesiology and Intensive Care, University Hospital, Uppsala, Sweden.
Acta Anaesthesiol Scand. 1993 Jan;37(1):60-4. doi: 10.1111/j.1399-6576.1993.tb03599.x.
It has previously been shown that a rapid, transient and pronounced reduction in superficial renal cortical blood flow can be elicited by injection of 1 ml of plasma into the left atrium of the anaesthetized pig. This renal vascular response might constitute an important error in measurements of renal blood flow by means of the microsphere technique. In the present study we have investigated total renal (ultrasonic Doppler) and superficial renal cortical (laser Doppler flowmetry) blood flow after left atrial injections of saline and autologous blood. The average reductions in total renal blood flow were 4.7 +/- 2.4% (mean +/- s.d.) and 18.4 +/- 12.5% (mean +/- s.d.) for the blood and saline injections, respectively. The flow reduction was more pronounced in the superficial renal cortex with average reductions of 17.4 +/- 26.0% (mean +/- s.d.) and 59.4 +/- 38.5% (mean +/- s.d.) for blood and saline, respectively (laser Doppler flowmetry). Furthermore, two consecutive injections of microspheres were performed. The results from the second injection were compared with those from the first injection. In the superficial renal cortex the second injection indicated a significant reduction in blood flow and an significantly increased heterogeneity in the blood flow in two different tissue volumes. No corresponding differences were found in the juxtamedullary cortex. These results indicate that the renal vascular response to a left atrial injection is detectable as a reduction in total renal blood flow and is most pronounced in the superficial renal cortex. All these results taken together constitute an important error in measurements of superficial renal cortical blood flow by the microsphere technique.
先前的研究表明，向麻醉猪的左心房注射1毫升血浆可引起肾皮质浅表血流迅速、短暂且显著减少。这种肾血管反应可能是微球技术测量肾血流时的一个重要误差来源。在本研究中，我们调查了左心房注射生理盐水和自体血后总的肾血流（超声多普勒法）和肾皮质浅表血流（激光多普勒血流仪法）。血液注射和生理盐水注射后总的肾血流平均减少分别为4.7±2.4%（均值±标准差）和18.4±12.5%（均值±标准差）。肾皮质浅表血流减少更为明显，血液注射和生理盐水注射后的平均减少分别为17.4±26.0%（均值±标准差）和59.4±38.5%（均值±标准差）（激光多普勒血流仪法）。此外，进行了两次连续的微球注射。将第二次注射的结果与第一次注射的结果进行比较。在肾皮质浅表，第二次注射显示血流显著减少，且在两个不同组织体积中的血流异质性显著增加。在近髓质皮质未发现相应差异。这些结果表明，左心房注射引起的肾血管反应可表现为总的肾血流减少，且在肾皮质浅表最为明显。所有这些结果共同构成了微球技术测量肾皮质浅表血流时的一个重要误差。
