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肾脏是生成尿液,维持机体水、电解质、酸碱平衡及排出机体代谢废物的重要器官。为保证上述机能的完成,肾脏血液非常丰富。肾动脉直接自腹主动脉发出,肾血流量占心搏出量的20％。因此当心脏骤停,循环停止,或心脏复苏后维持较长时间的低血压,均可造成肾脏的血液供应发生急剧改变,由于肾素-血管紧张素系统功能紊乱,产生过多的血管紧张素Ⅱ,导致肾血管的强烈收缩,肾血流量严重减少,肾脏严重缺血。如缺血超过一定时间则肾小球滤过率降低,肾小管发生功能障碍,最后必定导致肾小管急性坏死,引起急性肾功能衰竭。这种缺血引起的肾血管收缩,即使在自主心跳已经恢复而机体仍处于低血压状态并持续30～60分钟以上时,常使肾小管阻力成倍增高,甚至在经过各种治疗已使有效循环恢复,动脉压正常的情况下,肾血流量的减少仍可持
Kidney is an important organ that generates urine, maintains body water, electrolyte, acid-base balance and excretes body waste. To ensure the completion of the above functions, kidney blood is very rich. Renal artery directly from the abdominal aorta, renal blood flow accounted for 20% of stroke volume. Therefore, cardiac arrest, circulatory arrest, or hypotension that persists for a long time after cardiopulmonary resuscitation can cause a drastic change in the blood supply to the kidneys, resulting in excessive angiotensin production due to dysfunction of the renin-angiotensin system Ⅱ, leading to a strong contraction of renal blood vessels, severe reduction of renal blood flow, severe renal ischemia. If the ischemia for more than a certain period of time reduce the glomerular filtration rate, tubular dysfunction, the final will inevitably lead to acute tubular necrosis, causing acute renal failure. This ischaemia-induced renal vasoconstriction often causes doubling of tubular resistance even after the spontaneous heartbeat has recovered and the body is still hypotensive for more than 30 to 60 minutes, even after various treatments have been effective Circulation recovery, arterial pressure normal circumstances, the reduction of renal blood flow can still be maintained