Sabatini S
Department of Physiology, Texas Tech University Health Sciences Center, Lubbock, 79430, USA.
Am J Kidney Dis. 1996 Jul;28(1 Suppl 1):S34-8. doi: 10.1016/s0272-6386(96)90567-3.
The nonnarcotic analgesics have been implicated as a significant cause of chronic renal failure worldwide. Epidemiologic studies of habitual abuse and necropsy studies show a strong relationship between the two. Animal studies designed to elucidate underlying mechanisms have been hampered because the lesion occurs infrequently and only after very high doses are given for prolonged periods; however, the Fischer 344 and Wistar rats appear to be more sensitive, and substantial new information should be forthcoming. In this review, some of the evidence for the possible mechanisms of papillary necrosis are presented: prostaglandin inhibition, reduction or redistribution of renal blood flow, direct cellular injury, free radical formation, and immunologic injury. At present, most data support prostaglandin inhibition and reduction or redistribution of renal blood flow, but direct cellular injury also appears to be very important.
在全球范围内，非麻醉性镇痛药已被视为慢性肾衰竭的一个重要病因。对习惯性滥用的流行病学研究以及尸检研究表明，二者之间存在密切关联。旨在阐明潜在机制的动物研究受到了阻碍，因为这种损伤很少发生，且只有在长时间给予非常高的剂量之后才会出现；然而，Fischer 344大鼠和Wistar大鼠似乎更敏感，预计将会有大量新信息问世。在这篇综述中，我们介绍了一些关于乳头坏死可能机制的证据：前列腺素抑制、肾血流减少或重新分布、直接细胞损伤、自由基形成以及免疫损伤。目前，大多数数据支持前列腺素抑制以及肾血流减少或重新分布，但直接细胞损伤似乎也非常重要。
