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甲状旁腺切除对犬类诱导性肾衰竭的影响。

Effects of parathyroidectomy on induced renal failure in dogs.

作者信息

Finco D R, Brown S A, Crowell W A, Hoenig M E, Ferguson D C, Brown C A, Cooper T A

机构信息

Department of Physiology, College of Veterinary Medicine, University of Georgia, Athens 30602, USA.

出版信息

Am J Vet Res. 1997 Feb;58(2):188-95.

PMID:9028487
Abstract

OBJECTIVE

To determine the effects of parathyroid hormone (PTH) depletion on dogs with induced chronic renal failure.

ANIMALS

2 groups of 26 mixed-breed dogs of both sexes (13 were parathyroidectomized [PTX] and 13 had sham surgery).

PROCEDURE

After surgical reduction of renal mass and PTX, dogs were selected for a 24-month period of study and monitored for clinical, hematologic, blood biochemical, and organ function status. On development of uremia or after 24 months, dogs were euthanatized, and tissues were examined.

RESULTS

Higher survival rate and smaller decrement in renal function (glomerular filtration rate) were observed in PTX dogs, compared with those that had sham surgery, but values did not reach statistical significance. The PTX dogs remained hypocalcemic during the study and had lower serum Ca2+ X P product values. Regardless of parathyroid state, survivors and fatalities could be separated on the basis of serum Ca2+ X P product values. Parathyroidectomy did not prevent renal deposition of calcium, and renal lesions were poorly correlated with renal cortical calcium concentration. Abnormalities reported in dogs with renal failure, which were attributed to PTH (glucose intolerance, pulmonary hypertension), were not observed in PTX dogs or those that had sham surgery.

CONCLUSIONS AND CLINICAL RELEVANCE

PTX had beneficial effects, but these were mediated via changes in mineral homeostasis rather than via direct effects of PTH. Results attributable to PTX were similar to those previously obtained by dietary restriction of phosphate intake.

摘要

目的

确定甲状旁腺激素(PTH)缺乏对诱导性慢性肾衰竭犬的影响。

动物

2组,每组26只雌雄混合的杂种犬(13只进行了甲状旁腺切除术[PTX],13只进行了假手术)。

程序

在手术减少肾质量和进行PTX后,选择犬进行为期24个月的研究,并监测其临床、血液学、血液生化和器官功能状态。在出现尿毒症或24个月后,对犬实施安乐死并检查组织。

结果

与接受假手术的犬相比,PTX犬的生存率更高,肾功能(肾小球滤过率)下降幅度更小,但这些值未达到统计学显著性。PTX犬在研究期间一直处于低钙血症状态,血清Ca2+×P乘积值较低。无论甲状旁腺状态如何,存活犬和死亡犬可根据血清Ca2+×P乘积值区分开来。甲状旁腺切除术并不能防止钙在肾脏沉积,肾脏病变与肾皮质钙浓度的相关性较差。肾衰竭犬中报告的归因于PTH的异常情况(葡萄糖不耐受、肺动脉高压)在PTX犬或接受假手术的犬中未观察到。

结论及临床意义

PTX具有有益作用,但这些作用是通过矿物质稳态的变化介导的,而不是通过PTH的直接作用。PTX的结果与先前通过饮食限制磷摄入获得的结果相似。

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