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静脉输注胰高血糖素对健康人肾血流动力学及肾小管钠处理的影响。

Effect of intravenous glucagon infusion on renal haemodynamics and renal tubular handling of sodium in healthy humans.

作者信息

Schwartz Sørensen S, Eiskjaer H, Orskov H, Bjerregaard Pedersen E

机构信息

Department of Nephrology and Medicine C, Skejby Hospital, Aarhus, Denmark.

出版信息

Scand J Clin Lab Invest. 1993 Feb;53(1):25-34. doi: 10.3109/00365519309092528.

Abstract

The effects of a 2-h intravenous infusion of glucagon 5 ng kg-1 min-1 or placebo on glomerular filtration rate (GFR), renal plasma flow (RPF), tubular sodium handling as judged by the lithium clearance method, and plasma concentrations of angiotensin II (AngII), aldosterone (Aldo), and atrial natriuretic factor (ANF) were investigated in two groups of healthy human volunteers, glucagon group (n = 10), and placebo group (n = 10). Glucagon infusion resulted in a maximal increase in plasma concentrations of glucagon of 400%. GFR increased 5.9% (range 1.3-12.4, p < 0.001) through the whole infusion period, whereas RPF only increased transiently during the first hour of infusion 6.5% (range 2.6-15.3, p < 0.05). Whereas filtered load of sodium increased significantly in response to glucagon infusion (p < 0.001), urinary sodium excretion was unchanged. Neither of these variables were affected by placebo. As judged from assessments of tubular sodium handling derived from the renal clearance of lithium, the increased filtered load of sodium resulted in an increase in the output of sodium from the proximal tubules of a similar magnitude, and an increase in absolute reabsorption of sodium in the distal tubules totally counterbalancing this increased input to the distal tubules. These alterations in tubular sodium handling did not involve Ang II, Aldo, or ANF. We conclude that an increase in plasma concentration of glucagon within the physiological range is capable of inducing a small and sustained increase in GFR, whereas RPF increases only transiently.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在两组健康人类志愿者(胰高血糖素组,n = 10;安慰剂组,n = 10)中,研究了以5 ng kg-1 min-1的速率静脉输注胰高血糖素2小时或输注安慰剂对肾小球滤过率(GFR)、肾血浆流量(RPF)、通过锂清除率法判断的肾小管钠处理以及血管紧张素II(AngII)、醛固酮(Aldo)和心房利钠因子(ANF)血浆浓度的影响。输注胰高血糖素导致血浆胰高血糖素浓度最大增加400%。在整个输注期间,GFR增加了5.9%(范围为1.3 - 12.4,p < 0.001),而RPF仅在输注的第一小时短暂增加了6.5%(范围为2.6 - 15.3,p < 0.05)。尽管输注胰高血糖素后钠滤过负荷显著增加(p < 0.001),但尿钠排泄未改变。这些变量均未受安慰剂影响。根据锂肾清除率评估肾小管钠处理情况判断,钠滤过负荷增加导致近端小管钠输出量增加幅度相似,远端小管钠绝对重吸收增加完全抵消了远端小管输入的增加。肾小管钠处理的这些改变不涉及Ang II、Aldo或ANF。我们得出结论,生理范围内血浆胰高血糖素浓度的增加能够诱导GFR出现小幅持续增加,而RPF仅短暂增加。(摘要截断于250字)

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