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高血糖导致肾脏高灌注的机制研究

The mechanisn of renal hyperperfusion induced byhyperglycemia

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【作者】 祁忠华林善锬郝传明顾亚明李俊

【Author】 Qi Zhonghua; Lin Shanyan; HaoChuanming, et al. (Neforotogy Research Laboratory,Hua Shan Hospital, Shanghai Medical University.Shanghai 200040)

【机构】 上海医科大学华山医院肾病研究室

【摘要】 探讨了高血糖对整体大鼠和离体灌注鼠肾(IPRK)血流动力学的影响及其机制。结果显示:高血糖在整体大鼠和IPRK均可引起肾血浆流量(RPF)、肾小球滤过率(GFR)的增加;在IRPK阻断管-球反馈后,高血糖不再能诱发上述改变;结构和葡萄糖相似的D-α-甲基-葡萄糖苷在IPRK可引起与相同渗透浓度的葡萄糖相似的RPF,GFR增加;血红蛋白不改变高血糖对肾血流动力学的影响。提示:高血糖可支接引起肾脏高灌注、高滤过,其机制主要是对管一球反馈的抑制,此抑制效应可能与葡萄糖的结构相关。内皮由来性舒张因子(EDRF)在高血糖导致的IPRK高灌注中不起主要作用。

【Abstract】 sing whole body clearance technique as well asisolated perfusedrat kidney (IPRK). We studied theeffect of hyperglycemia on renai hemodynamics andthe possible mechanism involved. Hyperglycemia in-creased renal plasma flow (RPF) and glomerularfiltration rate (GFR). In nonfiltering isolated perfusedrat kidney or after adding furosemide to the perfusate,both techniques were believed to abolish thetubuloglomerular feedback, the renal hemodynamicchanges induced by hyperglyeemia disappeared, butadding sodium nitroprusside increased RPF and de-creased renal vascular resistance (RVR). D-α-methyl- glucoside, a glucose derivative, increased RPFand GFR in IPRK. but had no influence on renalhemodynamics in whole body clearance study.Hemoglobin, which could block the action ofendotheliumderived relaxing factor (EDRF), did notchange the effects of hyperglycemia on renalhemodvnamics in IPRK. These results indicated thathyperglycemia could directly induce hyperperfusionand hyperfiltration, which is mainly mediated by sup-pression of tubuloglomerular feedback. EDRF do notplay the major role in the changes of hemodynamicsinduced by hyperglycemia.

【关键词】 血糖过多血液灌注动物实验
【Key words】 Hyperglycemia Kidney Ani-mals. laboratory
【基金】 国家自然科学基金,纽约中华医学基金
  • 【文献出处】 中华医学杂志 ,NATIONAL MEDICAL JOURNAL OF CHINA , 编辑部邮箱 ,1994年01期
  • 【分类号】R587.1
  • 【被引频次】15
  • 【下载频次】108
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