Huang W C, Tsai R Y
From the Graduate Institute of Medical Sciences, Tzu Chi College of Medicine, Hualien, Taiwan, Republic of China.
Hypertension. 1998 Sep;32(3):534-40. doi: 10.1161/01.hyp.32.3.534.
Surgical correction of renal artery stenosis in Goldblatt hypertension rapidly normalizes blood pressure and increases renal function. This study was conducted in 1-kidney, 1 clip (1K1C) Goldblatt hypertensive rats to examine whether the unclipping-induced reversal of blood pressure and renal function is mediated by nitric oxide (NO). The 1K1C rats were prepared and given tap water with or without supplementation of NG-nitro-L-arginine methyl ester (L-NAME). Systolic blood pressure (SBP) before and after renal artery clipping was measured with the tail-cuff method. Four weeks later, surgical unclipping was performed while blood pressure and renal function responses were determined. The results show that clipping the renal artery for 4 weeks increased SBP from 140+/-5 to 183+/-6 mm Hg (P<0.05). Concurrent L-NAME treatment accelerated and aggravated the clipping-induced increases in SBP from 138+/-6 to 219+/-8 mm Hg (P<0.05). Surgical unclipping reduced blood pressure to normotensive levels within 2 hours in all hypertensive rats with and without chronic or acute L-NAME treatment. However, the magnitude of reductions in blood pressure in the initial 1 hour after unclipping was significantly less in L-NAME-treated rats than in nontreated rats (9+/-2% versus 16+/-1%, P<0.05). Despite reducing blood pressure, unclipping significantly increased glomerular filtration rate, urine flow, and sodium and potassium excretions, but the extent of the increases in these renal functions was significantly attenuated in L-NAME-treated rats. These data suggest that NO production partly contributes to the hypotensive and renal responses to unclipping but does not mediate the reversal of renovascular hypertension of this model.
在戈德布拉特高血压模型中,对肾动脉狭窄进行手术矫正可使血压迅速恢复正常并改善肾功能。本研究在单肾单夹(1K1C)戈德布拉特高血压大鼠中进行,以探讨解除夹闭所致的血压和肾功能逆转是否由一氧化氮(NO)介导。制备1K1C大鼠,并给予含或不含NG-硝基-L-精氨酸甲酯(L-NAME)的自来水。采用尾套法测量肾动脉夹闭前后的收缩压(SBP)。四周后,进行手术解除夹闭,同时测定血压和肾功能反应。结果显示,肾动脉夹闭4周使SBP从140±5 mmHg升高至183±6 mmHg(P<0.05)。同时给予L-NAME治疗加速并加重了夹闭所致的SBP升高,从138±6 mmHg升至219±8 mmHg(P<0.05)。在所有高血压大鼠中,无论是否接受慢性或急性L-NAME治疗,手术解除夹闭均在2小时内使血压降至正常水平。然而,解除夹闭后最初1小时内,L-NAME治疗组大鼠的血压下降幅度明显小于未治疗组(9±2%对16±1%,P<0.05)。尽管解除夹闭降低了血压,但显著增加了肾小球滤过率、尿流量以及钠和钾排泄,但L-NAME治疗组大鼠这些肾功能的增加程度明显减弱。这些数据表明,NO的产生部分促成了解除夹闭后的降压和肾脏反应,但并未介导该模型肾血管性高血压的逆转。