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主动脉夹闭对大鼠近端重吸收和钠排泄的影响。

Effect of aortic clamping on proximal reabsorption and sodium excretion in the rat.

作者信息

Osgood R W, Lameire N H, Sorkin M I, Stein J H

出版信息

Am J Physiol. 1977 Feb;232(2):F92-6. doi: 10.1152/ajprenal.1977.232.2.F92.

Abstract

It has been suggested that aortic clamping prior to expansion of the extracellular fluid volume prevents the natriuretic response normally seen in this setting. To further evaluate this finding, two groups of re-collection micropuncture studies were performed before and after 7.5% body wt expansion with Ringer solution. Group I, immediate-clamp studies, n, 11. After control collections, perfusion pressure to the left kidney was decreased to 75 mmHg followed by Ringer loading. Group II, delayed-clamp studies, n, 8. After control collections, Ringer solution was given for 40 min. Then the left renal perfusion pressure was reduced to 75 mmHg and the Ringer infusion was continued at the same rate. In the immediate-clamp group, there was no change in total kidney glomerular filtration rate (GFR) (1.16 vs. 1.11 ml/min), nephron GFR (40 vs. 39 nl/min), tubular fluid-to-plasma inulin ratio (2.40 vs. 2.28), or filtrate delivery out of the proximal tubule (18 vs. 18 ndium excretion were not significantly altered. In the delayed-clamp studies, there was also no change in total or nephron GFR, but the tubular fluid-to-plasma inulin ratio fell from 2.52 to 1.65 (P less than .001) and distal delivery rose 9 nl/min after expansion (P less than .001). Sodium excretion increased 3.83 mueq/min and fractional sodium excretion rose 2.28%, both values being markedly greater than in the immediate-clamp studies (P less than .005 for both). These results demonstrate that immediate clamping obviates the fall in proximal reabsorption and the natriuretic response to Ringer loading and suggests that intrarenal adjustments are a major determinant of the magnitude of the natriuretic response to expansion of the extracellular volume

摘要

有人提出,在细胞外液量扩充之前进行主动脉钳夹可防止在此情况下通常出现的利钠反应。为了进一步评估这一发现,在使用林格溶液使体重增加7.5%之前和之后进行了两组再收集微穿刺研究。第一组,即刻钳夹研究,n = 11。在对照收集后,左肾灌注压降至75 mmHg,随后给予林格溶液。第二组,延迟钳夹研究,n = 8。在对照收集后,给予林格溶液40分钟。然后将左肾灌注压降至75 mmHg,并以相同速率继续输注林格溶液。在即刻钳夹组中,总肾肾小球滤过率(GFR)(1.16对1.11 ml/分钟)、肾单位GFR(40对39 nl/分钟)、肾小管液与血浆菊粉比率(2.40对2.28)或近端小管滤过液排出量(18对18)均无变化,钠排泄也无显著改变。在延迟钳夹研究中,总GFR或肾单位GFR也无变化,但肾小管液与血浆菊粉比率从2.52降至1.65(P小于0.001),扩充后远端排出量增加9 nl/分钟(P小于0.001)。钠排泄增加3.83 μeq/分钟,钠排泄分数增加2.28%,这两个值均明显高于即刻钳夹研究(两者P均小于0.005)。这些结果表明,即刻钳夹可避免近端重吸收下降和对林格溶液输注的利钠反应,并提示肾内调节是细胞外液量扩充时利钠反应幅度的主要决定因素。

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