Prostaglandins: modulators of renal function and pressor resistance in chronic liver disease.
Prostaglandins: modulators of renal function and pressor resistance in chronic liver disease.
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前列腺素：慢性肝病肾功能和加压抵抗的调节剂。
DOI：
10.1210/jcem-48-6-895
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发表时间：
1979
期刊：
影响因子：
--
通讯作者：
R. Horton
中科院分区：
文献类型：
--
作者：
R. Zipser;J. Hoefs;P. Speckart;P. Zia;R. Horton
前列腺素可以调节肾功能，并在慢性肝病的肾素亢进和血管紧张素加压抵抗中发挥作用。为了研究这种可能性，我们评估了 12 名患有酒精性肝硬化和腹水的患者。 5 名女性患者的尿液免疫测定前列腺素 E 为 3.3 +/- 0.5 微克/天 [正常，0.3 +/- 0.1 (SE)]，肾素为 14.6 +/- 3.7 ng/ml.h，醛固酮为 76 +/- 19 ng/dl。使用吲哚美辛 (200 mg) 或布洛芬 (2000 mg) 1 天后，尿液免疫测定前列腺素 E 降至 0.8 +/- 0.4 微克/天，肾素降至 8.0 +/- 2.4 ng/mol.h，醛固酮降至 54 +/- 14 ng/dl（所有 P 均小于 0.01）。升压敏感性显着增加，肌酐清除率从 73 +/- 10 cc/min 短暂下降至 32 +/- 7 cc/min（P 小于 0.01）。由于对肾素的主要作用可能可以解释肾功能损害，因此另一项研究使用普萘洛尔来降低肾素活性。普萘洛尔不改变肾功能。我们得出的结论是，前列腺素在维持肾功能方面发挥支持作用，并参与肝病患者的肾素亢进和升压抵抗。
Prostaglandins may modulate renal function and play a role in the hyperreninism and angiotensin pressor resistance of chronic liver disease. To study this possibility, we evaluated 12 patients with alcoholic cirrhosis and ascites. Urine immunoassayable prostaglandin E in 5 female patients was 3.3 +/- 0.5 micrograms/day [normal, 0.3 +/- 0.1 (SE)], renin was 14.6 +/- 3.7 ng/ml.h, and aldosterone was 76 +/- 19 ng/dl. After either indomethacin (200 mg) or ibuprofen (2000 mg) for 1 day, urine immunoassayable prostaglandin E fell to 0.8 +/- 0.4 micrograms/day, renin to 8.0 +/- 2.4 ng/mol.h, and aldosterone to 54 +/- 14 ng/dl (all P less than 0.01). Pressor sensitivity increased dramatically, and creatinine clearance transiently fell from 73 +/- 10 to 32 +/- 7 cc/min (P less than 0.01). Because a primary effect on renin might explain the renal impairment, an additional study used propranolol to lower renin activity. Renal function was unaltered by propranolol. We conclude that prostaglandins play a supportive role in maintaining renal function and are involved in the hyperreninism and pressor resistance of patients with liver disease.