RED-CELL TRAPPING AFTER ISCHEMIA AND LONG-TERM KIDNEY DAMAGE - INFLUENCE OF HEMATOCRIT
RED-CELL TRAPPING AFTER ISCHEMIA AND LONG-TERM KIDNEY DAMAGE - INFLUENCE OF HEMATOCRIT
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DOI：
10.1038/ki.1990.107
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发表时间：
1990-05-01
影响因子：
19.6
通讯作者：
WOLGAST, M
中科院分区：
文献类型：
--
作者：
HELLBERG, POA;BAYATI, A;WOLGAST, M
本实验观察了红细胞压积（Hct）对大鼠肾微血管中红细胞（RBC）滞留的影响及其对肾缺血后远期预后的影响。结果表明，增加缺血时间增加红细胞捕获，51铬标记的红细胞，以剂量依赖性的方式。在正常Hct（46%）时，缺血产生半最大RBC捕获的时间为45分钟，而在血液稀释（Hct = 31%）或血液浓缩（Hct = 60%）后，相应的时间分别为80和25分钟。关于长期结果，Hct正常的45分钟缺血与恢复4周后肾重量、GFR和尿渗透压的显著降低相关，这在很大程度上可以通过血液稀释来预防。相反，在血液浓缩的情况下，仅在缺血25分钟后就有严重的损伤。这表明，这些长期影响是由于红细胞截留在外髓质的微血管系统，这可能会导致额外的缺血，在这方面的肾脏。还表明，皮质萎缩是继发于髓质损伤，并带来了避免广泛的水和盐的损失。
The influence of the hematocrit (Hct) on the trapping of red blood cells (RBC) in the renal microvasculature and its effect on the long-term outcome following unilateral ischemia were investigated in the rat. The results showed that an increase in the duration of ischemia increased the RBC trapping, as measured by 51Cr-labeled erythrocytes, in a dose-dependent manner. At normal Hct (46%) the period of ischemia producing half-maximum RBC trapping was 45 minutes, whereas after hemodilution (Hct = 31%) or hemoconcentration (Hct = 60%) the corresponding periods were 80 and 25 minutes, respectively. Regarding the long-term outcome, 45 minutes of ischemia with a normal Hct was associated with a marked decrease in kidney weight, GFR and urine osmolarity after four weeks of recovery, which could be prevented to a large extent by hemodilution. Conversely, with hemoconcentration there was severe damage after only 25 minutes of ischemia. It is suggested that these long-term effects are attributable to RBC trapping in the microvasculature of the outer medulla, which may cause added ischemia in this area of the kidney. It is also suggested that cortical atrophy is secondary to the medullary injury, and is brought about to avoid extensive water and salt losses.