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利尿剂在少尿病人的处理中仍然是有争议的,一些专家赞成审慎地应用,另一些则坚持这些药物是没有价值甚或是有害的。为了澄清该一问题,作者复习了在急性肾功能衰竭(ARF)中使用利尿剂的理论基础,并对许多在实验中和临床研究中累积的资料作出评价。理论方面近来已经提出了四种主要的ARF的病理生理学机理:持久的肾血管收缩,小管梗阻,经损害的肾小管上皮回漏和肾小球的通透性改变。仅仅前两种机理与本课题有关,因为利尿疗法要恢复正常的肾小球通
Diuretics remain controversial in the treatment of oliguric patients, with some experts in favor of judicious application, others insisting that these drugs are of no value or even harmful. To clarify this issue, the authors reviewed the rationale for the use of diuretics in acute renal failure (ARF) and evaluated many of the data accumulated in experimental and clinical studies. In theory, four major pathophysiological mechanisms of ARF have recently been proposed: persistent renal vasoconstriction, tubule obstruction, damaged tubular epithelial leakage, and glomerular permeability changes. Only the first two mechanisms related to this topic, because diuretic therapy to restore normal glomerular pass