Статья
Ангиотензин II и предсердный натрийуретический пептид — единство и борьба противоположностей в модели реноваскулярной гипертензии «2 почки, 1 зажим». Метаанализ
К настоящему времени модель Голдблатт гипертензии «2 почки, 1 зажим» исследована в большом количестве экспериментальных работ. Известно, что активация ренин-ангиотензиновой системы (РАС) лежит в основе развития данной гипертензии. Основным буфером РАС является предсердный натрийуретический пептид (ПНП), уровень которого существенно повышается в ответ на рост артериального давления (АД) и высокую концентрацию ангиотензина II и ионов Na+. ПНП обладает выраженным гипотензивным действием. Клинические и экспериментальные исследования показывают, что унилатеральная реноваскулярная гипертензия (УРГ) развивается не всегда даже при существенном стенозе почечной артерии. Цель настоящей работы — исследовав с помощью метаанализа литературных данных активность РАС и ПНП, сдвиги в водно-электролитном балансе, а также симпатическую активность почечных нервов, изучить гипертензивные и гипотензивные механизмы в модели реноваскулярной гипертензии «2 почки, 1 зажим». Материалы и методы. Метаанализ был проведен при помощи статистической программы Review Manager 5.3 (Cochrane Library). В метаанализе были использованы данные 76 публикаций, посвященных экспериментальным исследованиям модели УРГ на крысах. Результаты и выводы. Проведенный нами метаанализ показал, что поддержание УРГ обеспечивается высокой активностью РАС и симпатической нервной системы, а также гипокалиемией и ремоделированием сердечно-сосудистой системы. Однако мы не получили убедительных доказательств влияния натрий-объем-зависимых механизмов на подъем АД при данной модели гипертензии.
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