Kim K M, Bogaert G A, Nguyen H T, Borirakchanyavat S, Kogan B A
Department of Urology, Seoul National University Children's Hospital, Korea.
J Urol. 1997 Sep;158(3 Pt 2):1090-3. doi: 10.1097/00005392-199709000-00103.
We studied renal hemodynamic changes after complete acute unilateral ureteral obstruction in the young lamb.
Seven 4-week-old lambs underwent unilateral complete ureteral obstruction and renal blood flow was monitored in both kidneys with ultrasonic flow transducers. Ureteral and arterial blood pressure was measured.
In the obstructed kidney renal blood flow was stable for 5 hours and then decreased thereafter to 71% of baseline at 5 days (p < 0.05). In the contralateral kidney the pattern of renal blood flow constituted a mirror image, although the magnitude of the increase was decreased (122% of baseline at 5 days, not statistically significant). Mean arterial blood pressure did not change in 5 days. Mean ureteral pressure increased from a baseline of 9 to 37 mm. Hg (p < 0.001) 2 hours after obstruction but gradually decreased to 24 mm. Hg after 24 hours and remained elevated for 5 days (p < 0.001).
The pattern of renal blood flow and ureteral pressure response to obstruction in the young lamb is different from that previously reported. Renal blood flow does not increase after obstruction and it is relatively preserved at 5 days. This unexpected response may be a result of the compound caliceal sheep kidney, immaturity of the young vascular system or development differences in the mechanism of spontaneous decompression of the collecting system.
我们研究了幼龄羔羊急性单侧输尿管完全梗阻后的肾脏血流动力学变化。
7只4周龄羔羊接受单侧输尿管完全梗阻,并用超声血流换能器监测双肾的肾血流。测量输尿管和动脉血压。
梗阻侧肾脏肾血流在5小时内保持稳定,此后下降,至5天时降至基线的71%(p<0.05)。对侧肾脏肾血流模式呈镜像改变,尽管增加幅度减小(5天时为基线的122%,无统计学意义)。平均动脉血压在5天内未改变。梗阻后2小时,平均输尿管压力从基线的9mmHg升至37mmHg(p<0.001),但24小时后逐渐降至24mmHg,并在5天内持续升高(p<0.001)。
幼龄羔羊肾血流和输尿管压力对梗阻的反应模式与先前报道的不同。梗阻后肾血流不增加,且在5天时相对保持。这种意外反应可能是由于复合肾盂羊肾、幼龄血管系统不成熟或集合系统自发减压机制的发育差异所致。