Glomerular hyperfiltration during sympathetic nervous system activation in early essential hypertension.
Glomerular hyperfiltration during sympathetic nervous system activation in early essential hypertension.
复制标题
早期原发性高血压交感神经系统激活期间肾小球过度滤过。
DOI：
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发表时间：
1997
影响因子：
13.6
通讯作者：
F. Luft
中科院分区：
文献类型：
--
作者：
R. Schmieder;R. Veelken;H. Schobel;P. Dominiak;J. Mann;F. Luft
肾小球高滤过可能在高血压的发生发展中起重要作用。肾素-血管紧张素系统和交感神经系统都影响肾血流动力学调节。为了验证交感神经系统激活可以揭示肾小球高滤过的假说，对45名血压正常的年轻人和37名患有轻度高血压的年轻人进行了静息和精神应激时肾血流动力学和肾素-血管紧张素系统体液成分的检测。用菊糖和对氨基马尿酸清除法测定静息和应激状态下的GFR和肾血浆流量(RPF)。在静息状态下，正常血压和高血压患者的RPF、GFR、滤过分数、血浆肾素活性、血管紧张素II浓度和血清醛固酮值相似。应激后，血压升高(P<；0.01)，但在正常血压和高血压患者中几乎相同(7.05+/-6.9对7.03+/-4.6毫米汞柱，NS)。RPF下降(-27+/-54比-22+/-25ml/min/1.73m2，NS)在两组中也相似。相反，高血压组肾小球滤过率(+10.5+/-7.2vs6.08+/-5.7ml/min)和滤过分数(+2.48+/-1.38vs1.82+/-1.49%，P<；0.001)较正常血压组显著增加。伴随而来的Ang II浓度升高在高血压组大于正常血压组(+4.6+/-1.0pg/ml对-1.0+/-0.45pg/ml，P<；0.001)。精神应激时肾小球滤过率的升高与血管紧张素Ⅱ浓度的升高呈正相关(r=0.39，P&0.001)。与安慰剂控制期相比，用血管紧张素转换酶抑制剂阻断肾素-血管紧张素系统可以减轻高血压患者应激期间GFR的增加(每1.73平方米8.04+/-5.01比10.1+/-5.7毫升/分钟，P<；0.05)，但对正常血压的受试者没有影响。即使在早期高血压患者，在交感神经系统激活时，肾小球高滤过也是明显的，这是由肾小球后血管收缩所介导的。这种早期应激诱导的肾小球高滤过可能促进或触发高血压的发展。
Glomerular hyperfiltration may be important for the development of essential hypertension. Both the renin-angiotensin system and the sympathetic nervous system influence renal hemodynamic regulation. To test the hypothesis that glomerular hyperfiltration can be unmasked by sympathetic nervous system activation, renal hemodynamics and humoral components of the renin-angiotensin system were examined at rest and during mental stress in 45 young normotensive healthy subjects and 37 young people with mild essential hypertension. GFR and renal plasma flow (RPF) were determined with inulin and para-aminohippuric acid clearance at rest and during stress. At rest, RPF, GFR, filtration fraction, plasma renin activity, angiotensin (Ang) II concentrations, and serum aldosterone values were similar in normotensive and hypertensive subjects. After stress, blood pressure increased (P < 0.01), but this was nearly identical in normotensive and hypertensive subjects (7.05 +/- 6.9 versus 7.03 +/- 4.6 mmHg, NS). The decrease in RPF (-27 +/- 54 versus -22 +/- 25 ml/min per 1.73 m2, NS) was also similar in the two groups. In contrast, the increase in GFR (+ 10.5 +/- 7.2 versus 6.08 +/- 5.7 ml/min per 1.73 m2, P < 0.001) and filtration fraction (+2.48 +/- 1.38 versus 1.82 +/- 1.49%, P < 0.05) was more marked in hypertensive than in normotensive subjects. The concomitant increase in Ang II concentrations was greater in hypertensive than in normotensive subjects (+4.6 +/- 1.0 versus -1.0 +/- 0.45 pg/ml, P < 0.001). The increase in GFR during mental stress was correlated with the increment in Ang II concentrations (r = 0.39, P < 0.001). Compared with the placebo control phase, blockade of the renin-angiotensin system with an angiotensin-converting enzyme inhibitor attenuated the increase in GFR during stress in hypertensive (8.04 +/- 5.01 versus 10.1 +/- 5.7 ml/min per 1.73 m2, P < 0.05), but not in normotensive, subjects. Even in early essential hypertension, glomerular hyperfiltration is evident during sympathetic nervous system activation, which is mediated by postglomerular vasoconstriction. This early stress-induced glomerular hyperfiltration may contribute to, or trigger, the development of essential hypertension.
肾血管性高血压大鼠中血管紧张素 II-去甲肾上腺素能相互作用。
DOI：
10.1172/jci113092
发表时间：
1987
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
Zimmerman,JB;Robertson,D;Jackson,EK
通讯作者：
Jackson,EK
肾功能的神经控制：肾α肾上腺素受体的作用。
影响因子：
3
作者：
DiBona,GF
通讯作者：
DiBona,GF
血管紧张素 II 增加成年大鼠心脏中的心脏蛋白质合成。
DOI：
10.1152/ajpheart.1993.265.1.h238
发表时间：
1993
期刊：
The American journal of physiology
影响因子：
--
作者：
Geenen,DL;Malhotra,A;Scheuer,J
通讯作者：
Scheuer,J