The Effect of Metoclopramide Administration on Electrolyte Status and Activity of Renin-Angiotensin-Aldosterone System in Premature Infants
The Effect of Metoclopramide Administration on Electrolyte Status and Activity of Renin-Angiotensin-Aldosterone System in Premature Infants
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甲氧氯普胺对早产儿电解质状态和肾素-血管紧张素-醛固酮系统活性的影响
DOI：
10.1203/00006450-198509000-00008
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发表时间：
1985
影响因子：
3.6
通讯作者：
I. Csaba
中科院分区：
文献类型：
--
作者：
E. Sulyok;T. Ertl;L. Varga;J. Bódis;I. Csaba
摘要：本研究旨在确定内源性多巴胺是否有助于调节低出生体重早产儿的肾脏钠处理和肾素-血管紧张素-醛固酮系统的功能。12例早产儿，平均出生体重1420 g，平均胎龄29.2周，在17-23天用胃复安（MTC）0.1 mg/ kg/d治疗胃排空延迟、反流和腹胀。婴儿保持低（2-3 mEq/kg/天）或高（4-7 mEq/kg/天）钠饮食，以调节RAAS的活性。在MTC给药3天前后，采集血样，并在6名男婴中采集24小时尿液，以测定血浆和尿电解质、血浆肾素活性、血浆醛固酮浓度和尿醛固酮排泄。我们证明，血浆钠和钾浓度和血浆肾素活性没有改变MTC。另一方面，作为对MTC的响应，尿钠排泄显著增加（1.8 ±0.3与2.3 ±0.3 mEq/kg/天）和钾排泄减少（1.2 ±0.2 vs 0.8 ±0.1 mEq/kg/天）;血浆醛固酮浓度和尿醛固酮排泄量分别由治疗前的2101 ±274 pg/ml和2.91 ±0.52 μg/ml下降到治疗前的2101 ±274 pg/ml和2.91 ±0.52 μg/ml。MTC后分别为1500 ±207 pg/ml（p < 0.01）和2.21 ±0.43 μg/d（p < 0.01）。这些变化是独立的治疗前的激素水平。我们的结论是，低出生体重早产儿的内源性多巴胺对血浆肾素活性没有影响，而是增强而不是抑制醛固酮的产生和肾小管钠重吸收。
ABSTRACT: The present study has been carried out to define whether endogenous dopamine contributes to the regulation of renal sodium handling and the function of the renin-angiotensin-aldosterone system in low birth weight premature infants. Twelve premature infants with mean birth weight of 1420 g and mean gestational age of 29.2 wk were given metoclopramide (MTC) in a dose of 0.1 mg/ kg/day to treat delayed gastric emptying, regurgitation, and abdominal distension at the age of 17-23 days. Infants were kept on either a low (2-3 mEq/kg/day) or high (4-7 mEq/kg/day) sodium diet to modulate activity of RAAS. Prior to and after a 3-day period of MTC administration, blood samples were taken, and in six male infants 24-h urine collections were made to determine plasma and urine electrolytes, plasma renin activity, plasma aldosterone concentration, and urinary aldosterone excretion. We demonstrated that plasma sodium and potassium concentrations and plasma renin activity were not altered by MTC. On the other hand, in response to MTC, there was a significant increase in urinary sodium excretion (1.8 ±0.3 versus 2.3 ±0.3 mEq/kg/day) and a decrease in potassium excretion (1.2 ±0.2 versus 0.8 ±0.1 mEq/kg/day); plasma aldosterone concentration and urinary aldosterone excretion decreased significantly from initial values of 2101 ±274 pg/ml and 2.91 ±0.52 μg/day to 1500 ±207 pg/ml (p < 0.01) and 2.21 ±0.43 μg/day (p < 0.01), respectively, after MTC. These alterations were independent of the pretreatment hormone levels. We conclude that in low birth weight premature infants endogenous dopamine has no influence on plasma renin activity and enhances rather than inhibits aldosterone production and renal tubular sodium reabsorption.