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腺苷输注对麻醉猪肾功能、血浆心钠素和抗利尿激素浓度及中心血流动力学的影响。

Effects of adenosine infusion on renal function, plasma ANP and ADH concentrations and central hemodynamics in anesthetized pigs.

作者信息

Elias A N, Wesley R C, Gordon I L, Pandian M R, Vaziri N D

机构信息

University of California, Irvine, CA 92717, USA.

出版信息

Gen Pharmacol. 1997 Mar;28(3):429-33. doi: 10.1016/s0306-3623(96)00242-x.

Abstract
  1. The effect of high-dose adenosine administration on atrial natriuretic peptide (ANP) and antidiuretic hormone (ADH) release is not completely understood, and data concerning the effect of adenosine on renal and systemic hemodynamics in the pig are lacking. Measurements of central hemodynamics, renal blood flow and urine production were made in anesthetized pigs during infusion of adenosine. The relationship between these parameters and the plasma concentrations of ANP, ADH and renal renin production was examined. 2. Adenosine infusion at the rate of 140 mg/kg per minute resulted in a significant decrease in systolic, diastolic and mean arterial blood pressure as well as pulmonary arterial pressure. However, cardiac output and renal blood flow remained unchanged during adenosine infusion. Likewise, heart rate remained unchanged until the end of infusion when it increased significantly, Plasma ANP and ADH concentrations increased significantly within 30 min after adenosine infusion, reaching peak levels at 30 to 60 min. However, despite the significant decrease in arterial blood pressure, renal renin production did not change significantly. 3. The adenosine-induced rise in ANP, which is normally released by atrial stretch, may represent a direct effect of adenosine on the cardiac myocytes. The increase in ADH may be a result of decreased arterial blood pressure triggering stimulatory signals from the aortic arch and carotid body receptors to hypothalamic-pituitary sites of ADH production/release. Urine flow decreased dramatically within 30 min of adenosine infusion. Thus adenosine infusion at the given rate led to marked reduction in systemic and pulmonary arterial pressures without significant change in cardiac output, heart rate and renal blood flow. This was associated with a marked increase in plasma ANP and ADH levels with no significant change in renal renin production despite a marked reduction in arterial blood pressure. 4. Maintenance of renal blood flow despite marked reduction in perfusion pressure suggests that, at high doses, adenosine induces renal vasodilation in pigs as opposed to a combined afferent and efferent vasoconstriction known to occur under different experimental conditions.
摘要
  1. 高剂量腺苷给药对心房利钠肽(ANP)和抗利尿激素(ADH)释放的影响尚未完全明确,并且缺乏关于腺苷对猪的肾脏和全身血流动力学影响的数据。在麻醉猪输注腺苷期间,对其中心血流动力学、肾血流量和尿量进行了测量。研究了这些参数与ANP、ADH血浆浓度及肾脏肾素分泌之间的关系。2. 以每分钟140mg/kg的速率输注腺苷导致收缩压、舒张压和平均动脉血压以及肺动脉压显著降低。然而,在输注腺苷期间心输出量和肾血流量保持不变。同样,心率在输注结束前保持不变,直至输注结束时显著增加。腺苷输注后30分钟内,血浆ANP和ADH浓度显著升高,在30至60分钟时达到峰值水平。然而,尽管动脉血压显著降低,但肾脏肾素分泌并未显著改变。3. 通常由心房牵张释放的ANP因腺苷而升高,这可能代表腺苷对心肌细胞的直接作用。ADH的增加可能是动脉血压降低触发了来自主动脉弓和颈动脉体感受器至ADH产生/释放的下丘脑 - 垂体部位的刺激信号的结果。腺苷输注后30分钟内尿量急剧减少。因此,以给定速率输注腺苷导致全身和肺动脉压显著降低,而心输出量、心率和肾血流量无显著变化。这与血浆ANP和ADH水平显著升高相关,尽管动脉血压显著降低,但肾脏肾素分泌无显著变化。4. 尽管灌注压显著降低但肾血流量仍得以维持,这表明在高剂量时,腺苷在猪中诱导肾血管舒张,这与在不同实验条件下已知发生的入球小动脉和出球小动脉联合收缩相反。

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