Pathogenesis of oedema in chronic severe anaemia: studies of body water and sodium, renal function, haemodynamic variables, and plasma hormones.
Pathogenesis of oedema in chronic severe anaemia: studies of body water and sodium, renal function, haemodynamic variables, and plasma hormones.
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慢性严重贫血水肿的发病机制：体内水和钠、肾功能、血流动力学变量和血浆激素的研究。
DOI：
10.1136/hrt.70.4.357
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发表时间：
1993
影响因子：
--
通讯作者：
P. Harris
中科院分区：
文献类型：
--
作者：
I. Anand;Y. Chandrashekhar;R. Ferrari;P. Poole‐Wilson;P. Harris
背景--慢性严重贫血的患者经常保留盐和水。这些患者的液体潴留不是由心力衰竭引起的，确切的机制仍不清楚。这项研究旨在研究一些可能的机制。方法和结果-血液动力学变量，体液成分，肾功能和血浆激素的测定在4例慢性严重贫血引起的水肿（平均（SE）红细胞压积13（1.7））谁从来没有接受过任何治疗。心输出量增加（6.1（0.6）l/min/m2），右心房（7.8（1）mm Hg）、平均肺动脉（20.5（2.0）mm Hg）和平均肺动脉楔压（13（2.7）mm Hg）轻微增加。平均体循环动脉压（81（1.3）mm Hg）和体循环血管阻力（12.3（1.1）mm Hg x min x m2/l）较低。体内总水分（+14%）、细胞外体积（+32%）、血浆体积（+70%）和体内总交换性钠（+30%）显著增加。肾血流量中度降低（-46%），肾小球滤过率轻度降低（-24%）。血浆去甲肾上腺素（2.1倍）、肾素活性（15倍）、醛固酮（3.2倍）、生长激素（6.3倍）和心房利钠肽（12倍）显著增加。结论--慢性重度贫血引起的水肿患者存在盐和水潴留、肾血流量和肾小球滤过率降低以及神经激素激活，与心肌疾病引起的水肿患者相似。然而，与心肌病患者不同，贫血患者的心输出量高，全身血管阻力和血压低。这表明，低浓度的血红蛋白贫血患者的基础内皮源性舒张因子活性的抑制作用降低，并导致全身血管舒张。随之而来的低血压可能是神经激素激活和盐和水潴留的刺激。
BACKGROUND--Patients with chronic severe anaemia often retain salt and water. Fluid retention in these patients is not caused by heart failure and the exact mechanisms remain unclear. This study was designed to examine some of the possible mechanisms. METHODS AND RESULTS--Haemodynamic variables, body fluid compartments, renal function, and plasma hormones were measured in four patients with oedema caused by chronic severe anaemia (mean (SE) haematocrit 13 (1.7)) who had never received any treatment. Cardiac output was increased (6.1 (0.6) l/min/m2) and right atrial (7.8 (1) mm Hg), mean pulmonary arterial (20.5 (2.0) mm Hg), and mean pulmonary arterial wedge (13 (2.7) mm Hg) pressures were slightly increased. The mean systemic arterial pressure (81 (1.3) mm Hg) and systemic vascular resistance (12.3 (1.1) mm Hg x min x m2/l were low. There were significant increases in total body water (+14%), extracellular volume (+32%), plasma volume (+70%), and total body exchangeable sodium (+30%). Renal blood flow was moderately decreased (-46%) and the glomerular filtration rate was slightly reduced (-24%). There were significant increases in plasma noradrenaline (2.1-fold), renin activity (15-fold), aldosterone (3.2-fold), growth hormone (6.3-fold), and atrial natriuretic peptide (12-fold). CONCLUSION--In patients with oedema caused by chronic severe anaemia there is retention of salt and water, reduction of renal blood flow and glomerular filtration rate, and neurohormonal activation similar to that seen in patients with oedema caused by myocardial disease. However, unlike patients with myocardial disease, patients with anaemia have a high cardiac output and a low systemic vascular resistance and blood pressure. It is suggested that the low concentration of haemoglobin in patients with anaemia causes a reduced inhibition of basal endothelium-derived relaxing factor activity and leads to generalised vasodilatation. The consequent low blood pressure may be the stimulus for neurohormonal activation and salt and water retention.
DOI：
--
发表时间：
1985-03
期刊：
The Journal of pharmacology and experimental therapeutics
影响因子：
--
作者：
W. Martin;G. Villani;D. Jothianandan;R. Furchgott
通讯作者：
W. Martin;G. Villani;D. Jothianandan;R. Furchgott
通过长期增加血流量来增强内皮衍生因子的释放。
DOI：
10.1152/ajpheart.1988.255.3.h446
发表时间：
1988
期刊：
The American journal of physiology
影响因子：
--
作者：
Miller,VM;Vanhoutte,PM
通讯作者：
Vanhoutte,PM
缓激肽可增加培养的豚鼠气管平滑肌细胞中的 Na( )-K( ) 泵活性。
影响因子：
7.3
作者：
Dodson,AM;Rhoden,KJ
通讯作者：
Rhoden,KJ