Cowan B E, Shortliffe L M
Department of Urology, Stanford University School of Medicine, California, USA.
J Urol. 1998 Sep;160(3 Pt 1):882-6. doi: 10.1016/S0022-5347(01)62826-X.
Since abnormally elevated renal pelvic pressures may contribute to renal damage, we examined whether an anticholinergic agent could decrease elevated renal pelvic pressures. We have previously demonstrated in a rat model that renal pelvic pressures rise physiologically during normal bladder filling and high urinary flows; these pressures rise to abnormal levels during acute urinary tract infection (UTI). In these studies we investigated the effects of oxybutynin on the in vivo rat urinary tract. Simultaneous bladder and renal pelvic pressures were measured with and without oxybutynin at low (<2 ml./kg./hr.), moderate (2-10), high (10-20), and very high (>20) urinary flows while the rat bladder filled and emptied spontaneously. Although minimal differences were found between bladder filling pressures with and without oxybutynin, at higher urinary flows the renal pelvic pressure in oxybutynin treated rats was significantly lower than in nontreated animals. Indeed, when rats with urinary tract infection were treated with oxybutynin, their renal pelvic pressures were lower than those in uninfected rats. We conclude that oxybutynin affects rat upper urinary collecting system pressures, and is capable of decreasing abnormally elevated renal pelvic pressures due to urinary tract infection to normal or subnormal levels.
由于肾盂压力异常升高可能会导致肾损伤，我们研究了一种抗胆碱能药物是否能降低升高的肾盂压力。我们之前在大鼠模型中证明，在正常膀胱充盈和高尿流期间，肾盂压力会生理性升高；在急性尿路感染（UTI）期间，这些压力会升至异常水平。在这些研究中，我们调查了奥昔布宁对大鼠体内泌尿道的影响。在大鼠膀胱自然充盈和排空时，在低（<2毫升/千克/小时）、中（2 - 10）、高（10 - 20）和非常高（>20）尿流情况下，分别测量了给予和未给予奥昔布宁时膀胱和肾盂的压力。虽然给予和未给予奥昔布宁时膀胱充盈压力的差异极小，但在较高尿流时，用奥昔布宁治疗的大鼠的肾盂压力显著低于未治疗的动物。事实上，当用奥昔布宁治疗尿路感染的大鼠时，它们的肾盂压力低于未感染大鼠的肾盂压力。我们得出结论，奥昔布宁会影响大鼠上尿路集合系统压力，并且能够将因尿路感染导致的异常升高的肾盂压力降低至正常或低于正常水平。
