Captopril augments the renal response to an amino acid infusion in diabetic adults.
Captopril augments the renal response to an amino acid infusion in diabetic adults.
复制标题
卡托普利可增强成人糖尿病患者对氨基酸输注的肾脏反应。
DOI：
10.1152/ajprenal.1988.255.4.f755
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发表时间：
1988
期刊：
影响因子：
--
通讯作者：
Kopple,JD
中科院分区：
文献类型：
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作者：
Slomowitz,LA;Hirschberg,R;Kopple,JD
本研究考察了胰岛素依赖型糖尿病和肾功能正常的患者在接受转化酶抑制剂预处理后对氨基酸输注的反应是否发生改变。三组成年人分两次接受氨基酸输注，每次20分钟，每次间隔240分钟。1组（6名正常人）和2组（6名糖尿病患者）在开始第二次输注前120分钟服用卡托普利（12.5 mg）。第三组（4例糖尿病患者）未使用卡托普利。糖尿病患者肾血浆流量基线正常，如对氨基尿酸清除率（CPAH）和肾小球滤过率（GFR）所示。在第1组，CPAH的最大增幅与两组相似，分别为23 +/- 5%和15 +/- 3% (SE)；GFR的最大变化也显著且相似，分别为20 +/- 5%和20 +/- 6%。第2组CPAH和GFR在第一次输注时最大增幅分别为28 +/- 7%和23 +/- 6%。卡托普利给药后，CPAH和GFR的升高明显大于首次给药时（分别为64 +/- 8%，P < 0.002; 67 +/- 9%, P < 0.002）。在第3组糖尿病患者中，第一次输注与第二次输注的CPAH或GFR均无差异。因此，卡托普利增强了糖尿病患者对氨基酸负荷的肾脏血流动力学反应，而在正常成人中没有。
This study examined whether patients with insulin-dependent diabetes mellitus and normal renal function have an altered response to an amino acid infusion when they are pretreated with a converting-enzyme inhibitor. Three groups of adults received amino acid infusions for 20 min on two occasions separated by a 240-min interval. Groups 1 (6 normals) and 2 (6 diabetics) ingested captopril (12.5 mg) 120 min before starting the second infusion. Group 3 (4 diabetics) did not receive captopril. Diabetics had normal base-line renal plasma flow, as indicated by para-aminohippuric acid clearance (CPAH), and glomerular filtration rate (GFR). In group 1, the maximum increase in CPAH was significant and similar with both infusions, 23 +/- 5 vs. 15 +/- 3% (SE); maximal changes in GFR were also significant and similar, 20 +/- 5 vs. 20 +/- 6%. In Group 2, the maximal increase in CPAH and GFR with the first infusion was 28 +/- 7 and 23 +/- 6%, respectively. After captopril, the increases in CPAH and GFR were significantly greater than with the first infusion (64 +/- 8%, P less than 0.002, and 67 +/- 9%, P less than 0.002, respectively). In Group 3 diabetics, there was no difference in either CPAH or GFR with the first vs. the second infusion. Thus captopril enhances the renal hemodynamic response to an amino acid load in diabetic patients but not in normal adults.