甘露醇对血管活性物质的影响  

Effect of mannitol on vasoactive substances

作　　者：朱笑萍[1] 罗季安[1] 刘伏友[1] 彭佑铭[1] 

机构地区：[1]中南大学湘雅二医院肾内科,长沙410011

出　　处：《中南大学学报（医学版）》2007年第2期333-336,共4页Journal of Central South University ：Medical Science

摘　　要：目的:利用甘露醇(mannitol)诱导急性肾功能衰竭动物模型,观察不同剂量甘露醇对血管活性物质的影响,探讨甘露醇诱导急性肾功能衰竭(ARF)的可能机制。方法:将18只健康新西兰大白兔随机分为3组,分别给予小剂量甘露醇(n=6,2h内给予甘露醇)、生理盐水(n=6,2h内给予相同溶积生理盐水)、大剂量甘露醇并自由饮水(n=6;3d内给予甘露醇40～60g/kg),观察用药后血中肾素、血管紧张素、内皮素及心钠素浓度的变化。结果:小剂量甘露醇组用药后的血浆肾素、血管紧张素Ⅰ、血管紧张素Ⅱ、内皮素及心钠素浓度与对照组比较差异不明显(P>0.05);而大剂量并自由饮水组血浆肾素、血管紧张素Ⅰ、血管紧张素Ⅱ浓度明显高于对照组及小剂量组;血浆内皮素浓度明显低于对照组(P<0.05),但与小剂量组比较差异不显著;大剂量并自由饮水组血浆心钠素浓度与对照组及小剂量组比较差异无统计学意义(P>0.05)。结论:大剂量甘露醇可能通过影响肾素-血管紧张素系统(RAS),进一步降低肾血流量,参与诱导急性肾功能衰竭,但对血管内皮细胞的损伤并不明显。Objective To observe the changes of vasoactive substances in rabbits administered with mannitol at different dosages and to investigate the mechanism of acute renal failure （ARF） induced by massive mannitol administration. Methods Eighteen healthy male New Zealand rabbits were randomly divided into 3 groups： a minor-mannitol group （n = 6, mannitol 8 g/kg within 2 hours ） , a control group （ n = 6, saline of the same volume ） , and a massive mannitol group with free water taking （ n = 6, mannitol 40 - 60 g/kg within 3 days ）. The changes of renin, angiotensin-Ⅰ （ ang-Ⅰ ）, angiotensin-Ⅱ （ ang-Ⅱ ） , endothelin （ ET）, and atrial natriuretic factor （ ANF ） in the serum were observed. Results No significant changes in the renin, ang-Ⅰ , ang-Ⅱ, ET, and ANF in the serum were found between the minor mannitol group and the saline control group （P 〉 0.05）. In the massive mannitol group with free water taking, renin, ang-Ⅰ , and ang-Ⅱ in the serum increased significantly compared with the other 2 groups; ET in the serum decreased significantly compared with the saline control group （ P 〈 0.05 ） ; no significant change were found compared with the other 2 groups （ P 〉 0.05 ）. Conclusion mannitol administration is associated with a significant change of vasoactive s in the ANF in the serum ARF induced by massive substances.

关 键 词：甘露醇 肾功能衰竭 急性 肾素 血管紧张素 内皮素 心钠素 

分 类 号：R692.5[医药卫生—泌尿科学]